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Hypotonous maculopathy after trabeculectomy with subconjunctival 5-fluorouracil
R L Stamper1, M G McMenemy, M F Lieberman
1Department of Ophthalmology, California Pacific Medical Center, San Francisco 94115.
American Journal of Ophthalmology
|November 15, 1992
Summary
Trabeculectomy with antifibrosis therapy can cause vision loss (hypotonous maculopathy) in young, myopic patients. This complication, characterized by reduced visual acuity and retinal changes, is difficult to reverse.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Retinal Diseases
Background:
- Trabeculectomy success is improved with antifibrosis agents like 5-fluorouracil and mitomycin C.
- These agents aim to prevent scar tissue formation, enhancing surgical outcomes.
Observation:
- Hypotonous maculopathy developed in 8 eyes of 6 patients post-trabeculectomy with antifibrosis therapy.
- Maculopathy presented as vision loss, retinal striae, and choroidal folds without vascular leakage.
Findings:
- Younger, myopic patients (mean age 46, mean myopia -7.5D) were more prone to maculopathy.
- Older patients (mean age 73) with less myopia were less likely to develop this complication.
- Age and refractive error were statistically significant factors (P=.007 and P=.04).
Implications:
- Caution is advised when using trabeculectomy with antifibrosis therapy in young, myopic individuals.
- The findings highlight specific patient profiles at higher risk for vision-threatening complications.
- Further research may explore risk mitigation strategies for this patient subgroup.