Treatment of chronic postfiltration hypotony by intrableb injection of autologous blood
J. B. Wise
Baptist Medical Center of Oklahoma, Oklahoma City.
OBJECTIVE--To treat chronic hypotony with decreased vision after filtration
surgery. DESIGN--After observation from 3 1/2 to 13 months with no
spontaneous improvement, eyes were treated with the experimental therapy
and followed up closely to determine the results. PATIENTS--Four eyes with
chronic hypotony, selected from a series of 125 eyes receiving
trabeculectomy augmented by intraoperative mitomycin. All eyes had
posterior chamber pseudophakia. All eyes had postoperative laser cutting of
sutures holding the scleral flap of the trabeculectomy. INTERVENTION--After
administration of topical prophylactic 0.3% ciprofloxacin hydrochloride and
topical anesthetic, the bleb was inflated with whole autologous blood
through a 27-gauge needle passed subconjunctivally into the bleb. MAIN
OUTCOME MEASURES--Change in intraocular pressure, change in vision, change
in choroidal detachment, any type of complication. RESULTS--Average
intraocular pressure increased from 5.5 to 8.2 mm Hg. Average vision
improved from 20/148 to 20/33. In two eyes with choroidal detachment, the
detachment absorbed in one eye and decreased in the other. No complications
occurred. CONCLUSION--Intrableb injection of autologous blood deserves
further study as a possible treatment for hypotony following filtration.
