A case of glaucoma with choroidal hemangioma managed by nonpenetrating trabeculectomy

Background: Nonpenetrating trabeculectomy was used in a patient with glauco ma complicated by diffuse choroidal hemangioma. Case: A 12-year-old boy suffered from glaucoma with choroidal hemangioma in the left eye. Intraocular pressure was 28 mm Hg and visual acuity was 0.04 . Nonpenetrating trabeculectomy was then per-formed. Observations: Postoperative intraocular pressure was controlled at around 1 5 mm Hg with pilocarpine hydrochloride eye drops. Visual acuity and visual field were preserved over 19 months after the operation. Conclusions: An increase in aqueous outflow resistance was considered to be the major mechanism in the rise in intraocular pressure, based on distinct dilatation and tortuosity of the episcleral blood vessels and congestion o f Schlemm's canal. Therefore, construction of aqueous drainage by nonpenetr ating trabeculectomy was effective. Retaining the trabecular meshwork was a lso considered effective in controlling complications such as choroidal hem orrhage and postoperative flat anterior chamber. Jpn J Ophthalmol 2000;44:1 74-177 (C) 2000 Japanese Ophthalmological Society.