FIBRIN SEALANT IN THE MANAGEMENT OF COMPLICATED HYPOTONY AFTER TRABECULECTOMY

BACKGROUND AND OBJECTIVE: In the postoperative course of trabeculectom y, hypotony may cause choroidal detachment with shallowing of the ante rior chamber. If conservative medical treatment fails, a surgical revi sion may become necessary. To achieve only a temporary seal of the scl eral flap, a sub-conjunctival tamponade with fibrin glue was performed . PATIENTS AND METHODS: Two patients with corneal decompensation as a result of cornea-lens contact complicating hypotony with massive choro idal detachment are described. Hypotony occurred after trabeculectomy in one case and after combined cataract and glaucoma surgery in anothe r case, and was not correlated to a leaking bleb. Temporary tamponade of the scleral flap was achieved by subconjunctival injection of fibri n sealant. RESULTS: After the fibrin sealant was applied, the choroida l detachment resolved and intraocular pressure increased to normal. Du ring the follow-up period of 6 months, a functioning bleb developed. C ONCLUSION: Subconjunctival application of fibrin sealant is effective for temporary closure of the scleral flap after trabeculectomy in eyes with massive hypotony syndrome.