Ciliochoroidal effusion with persistent hypotony after trabectome surgery

• Main Authors: Essam A Osman, Faisal AlMobarak
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2015-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Intraocular; lymphoma; retina; vitreous; Conjunctiva; cornea; melanoma; ocular surface; ocular surface squamous neoplasia; tumor; Brachytherapy; chemotherapy; cryopexy; intra ocular tumors; photocoagulation; Animal uveitis model; cytomegalovirus retinitis animal model; endotoxin-induced uveitis; experimental autoimmune uveitis; spontaneous; tubercular uveitis animal model; India; genetics; retinoblastoma; review; Glaucoma; heavy silicone oil; light silicone oil; ocular hypertension; retinal detachment; standard silicone oil; Adults; blue sclera; keratoglobus; management; pediatric patients; Choroid; hypertension; optic coherence tomography; Choroidal thickness; enhanced depth imaging; hypothyroidism; intraocular pressure; optical coherence tomography; A pattern; disc foveal angle; intorsion; superior oblique split lengthening; Blind schools; cataract; corneal scar; hereditary diseases; ocular morbidity; prevention of blindness; Intraocular lens dislocation; ocular trauma; pseudophacocele; subconjunctival hemorrhage; Acrochordons; fibro-epithelial polyps; fibroma; giant soft fibroma; skin tags; Ascher′s syndrome; blepharochalasis; double upper lip; Laffer-Ascher′s syndrome; nontoxic goiter; Evaluation of Google; information on internet; medical information; patient counseling; patient information; web content; Deep orbital varix; endovascular coil embolization; transfemoral route; Ciliochoroidal effusion; cyclodialysis; trabeculectomy
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2015;volume=63;issue=3;spage=272;epage=274;aulast=Osman

The trabectome is a novel form of ab interno trabeculectomy that ablates and remove the trabecular meshwork and the inner wall of Schlemm′s canal and subsequently expose the natural drainage pathway (the collector channels) to aqueous humor. Complications associated with the trabectome are few and among them is transient hypotony. We report a case of a prolonged ciliochoroidal effusion with hypotony after ab interno trabeculectomy using the trabectome with cyclodialysis cleft detected by 80 MHz ultrasound biomicroscopy in a previously neither nonoperated nor traumatized eye. Transient hypotony has been reported after the trabectome surgery. Very few cases were associated with inadvertent intraoperative cyclodialysis, but there are no cases of prolonged hypotony with ciliochoroidal effusion with cyclodialysis. In our case, associated transient intraoperative and postoperative hypotony with a history of chronically high pressure along with the possible contribution of low-grade postoperative inflammation may have precipitated the ciliochoroidal effusion with prolonged hypotony associated with cyclodialysis.