Control of Intraocular Pressure After Trabeculectomy

• Published in: Survey of Ophthalmology Vol. 43; no. 4; pp. 345 - 355
• Main Authors: Haynes, William L, Alward, Wallace L.M
• Format: Book Review Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 1999; Elsevier Science
• Subjects: Biological and medical sciences; glaucoma; Glaucoma - surgery; Humans; hypotony; hypotony maculopathy; Intraocular Pressure; Medical sciences; overfiltration; Postoperative Care - methods; Postoperative Complications - therapy; releasable sutures; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; suture lysis; Tenon’s cyst; trabeculectomy; Trabeculectomy - adverse effects; wound leak; releasable sutures; wound leak; hypotony maculopathy; Tenon’s cyst; intraocular pressure; suture lysis; glaucoma; hypotony; overfiltration; trabeculectomy; Human; Postoperative; Trabeculectomy; Eye disease; Treatment; Ocular hypotension; Surgery; Check; Complication; Technique
• ISSN: 0039-6257; 1879-3304
• DOI: 10.1016/S0039-6257(98)00045-9

Control of intraocular pressure (IOP) is the goal of trabeculectomy, and pursuit of this goal does not end with the completion of the surgical procedure. Proper postoperative management of the trabeculectomy patient requires an understanding of possible events that alter IOP and knowledge of the treatments to control IOP. Recent changes in surgical technique, including the use of antimetabolites, have provided new challenges in the postoperative management of trabeculectomy patients. Interventions are described to restore the flow of aqueous to the filtering bleb in the early postoperative period, to manage flat anterior chambers with both high and low intraocular pressures, to manage a failing filtering bleb, and to manage hypotony. Herein we discuss current methods for controlling IOP in the postoperative period.