Management of hypotony maculopathy and a large filtering bleb after trabeculectomy with mitomycin C: Success with argon laser therapy

We report a patient with postkeratoplasty glaucoma that developed a large, filtering bleb following trabeculectomy with intraoperative antimetabolite treatment. The hypotony and the bleb were managed using argon laser photoco agulation. A 26-year-old female patient underwent penetrating keratoplasty in the left eye for keratoconus. Postoperatively, her elevated intraocular pressure could not be controlled medically, and the patient underwent a tra beculectomy with intraoperative antimetabolite application. Two months late r, hypotony maculopathy, optic disc edema, and choroidal folds developed, a nd her vision dropped. Steroid treatment and soft contact lenses did not he lp. Photocoagulation was applied twice to the surface of the bleb and the s urrounding area. After the photocoagulation therapy, the patient's vision i mproved, intraocular pressure increased, and the optic disc edema and macul ar folds had resolved. Argon laser photocoagulation applied to a large filt ering bleb associated with hypotony maculopathy is a useful treatment for b leb remodeling and elevating intraocular pressure.