USE OF OVERSIZED BANDAGE SOFT CONTACT-LENSES IN THE MANAGEMENT OF EARLY HYPOTONY FOLLOWING FILTRATION SURGERY

BACKGROUND AND OBJECTIVE: Initial overdrainage following filtration su rgery can be frustrating to manage. The authors reviewed the records o f 10 patients with early postoperative hypotony following filtration s urgery who were treated with application of an oversized 17.0-mm banda ge soft contact lens (BSCL). PATIENTS AND METHODS: Nine eyes had under gone trabeculectomy with either mitomycin-C or 5-fluorouracil intraope rative application, and one eye had undergone tenonectomy 4 years foll owing trabeculectomy. On postoperative day 1, seven eyes were hypotono us, and three other eyes became hypotonous following suture removal or lysis. An oversized 17.0-mm BSCL was placed immediately following the diagnosis of hypotony on all eyes except one, which had the BSCL appl ied after 24 hours of observation. RESULTS: In 9 of 10 cases intraocul ar pressure rose 5 to 12 mm Hg following placement of the BSCL. During a 6- to 18-month follow-up, all successfully treated eyes had final i ntraocular pressures of 5 to 11 mm Hg, with extensive low to moderate height blebs. CONCLUSION: Oversized BSCLs can be a useful tool in the management of early hypotony following filtration surgery.