Persistent Hypotony Following Antiglaucoma Surgery: A Case Report

TL;DR

A rare case of long-term low eye pressure after glaucoma surgery led to vision loss, but combined surgical treatment improved the patient's vision.

Contribution

Presents a successful treatment approach for persistent hypotony after antiglaucoma surgery.

Findings

Combined suprachoroidal drainage and phacoemulsification improved visual acuity and stabilized IOP.

Six months post-surgery, best corrected visual acuity reached 0.3.

Abstract

Background: Persistent hypotony is a rare but serious complication following antiglaucoma surgery. Identifying the cause and appropriate management is critical to prevent vision loss.

Case Presentation: A 56-year-old male presented with 6 months of progressive vision loss in the left eye, 20 years post-antiglaucoma surgery. Examination showed no light perception in the right eye and choroidal and ciliary body detachment with lens subluxation in the left eye. After a month of conservative treatment, intraocular pressure (IOP) in the left eye remained below 6 mmHg, necessitating surgical intervention. Combined suprachoroidal fluid drainage, phacoemulsification, and capsular tension ring implantation improved visual acuity and stabilized IOP. Six months postoperatively, the best corrected visual acuity (BCVA) was 0.3.

Conclusions: Prompt identification and treatment of persistent hypotony post-antiglaucoma surgery are essential for visual function restoration and complication prevention.

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