A case of glaucoma with choroidal hemangioma managed by nonpenetrating trabeculectomy

Nonpenetrating trabeculectomy was used in a patient with glaucoma complicated by diffuse choroidal hemangioma.

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 performed.

Postoperative intraocular pressure was controlled at around 15 mm Hg with pilocarpine hydrochloride eye drops. Visual acuity and visual field were preserved over 19 months after the operation.

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 of Schlemm's canal. Therefore, construction of aqueous drainage by nonpenetrating trabeculectomy was effective. Retaining the trabecular meshwork was also considered effective in controlling complications such as choroidal hemorrhage and postoperative flat anterior chamber.