TRABECULECTOMY FOR TRAUMATIC HYPHEMA WITH INCREASED INTRAOCULAR-PRESSURE

We reviewed the medical records of 11 consecutive patients who underwe nt trabeculectomy with anterior chamber washout and peripheral iridect omy as the primary surgical treatment for traumatic hyphema that was u nresponsive to medical management. The mean intraocular pressure befor e surgery was 48 mm Hg. In ten of the patients the intraocular pressur e was lowered to 21 mm Hg or lower after surgery and remained below th at level up to the most recent follow-up visit, which ranged from eigh t to 97 months. One patient required a topical beta-blocker and oral a cetazolamide to lower pressure to this level after surgery. Eight pati ents had visual acuity of 20/60 or better at last follow-up. Corneal b lood staining occurred in eight patients. Compared with other techniqu es for surgical management of traumatic hyphema, trabeculectomy provid es a means to keep intraocular pressure lowered while the remaining bl ood is clearing from the anterior chamber. Trabeculectomy with anterio r chamber washout and peripheral iridectomy appears td be a safe and r eliable procedure in the management of traumatic hyphemas in which med ical management fails to control intraocular pressure.