Trabeculectomy with anterior vitrectomy in aphakic and pseudophakic glaucoma

In 15 eyes with uncontrolled aphakic/pseudophakic glaucoma, trabeculectomy with anterior vitrectomy was performed. Mean pre-operative intraocular pressure (IOP) was 38.2 +/- 6.7 mmHg and mean post operative IOP was 19.3 +/- 5.2 mmHg after follow-up of 11.2 2 months. The anterior chamber maintainer technique during vitrectomy has been employed. Success rate (IOP less than 21 mmHg with or without glaucoma medication) was 80%. Visual acuity remained unchanged in 4 eyes, improved in 5 eyes and worsened in 6 eyes. Postoperative complications included: two eyes with cystoid macular edema, two eyes with choroidal effusion and prolonged hypotony, one eye with self-absorbing vitreous hemorrhage and one eye with some opacification of the corneal graft. In aphakic/pseudophakic glaucoma where vitreous is filling the anterior chamber--a combined trabeculectomy with anterior vitrectomy is indicated for removal of vitreous from the sclerostomy site with better aqueous flow through the sclerostomy and adequate control of IOP.