Extensive intracorneal deposition after compression sutures for the treatment of hypotony maculopathy

To report a case of extensive intrastromal corneal infiltration with opacification after compression suture placement for hypotony maculopathy.

Retrospective case report.

A 24-year-old Indian male with hypotony maculopathy after trabeculectomy was referred to us for management of overfiltration. Compression sutures were placed to reduce bleb size and area of filtration. Slit lamp photographs and bleb/corneal imaging with anterior segment optical coherence tomography were performed to document corneal infiltration.

After placement of the compression sutures in an attempt to delimit the large bleb, there was normalization of the intraocular pressure and improvement in visual acuity. However, the patient developed a wide area of corneal intrastromal deposition that did not extend into the visual axis and was not visually significant. The intrastromal location of the infiltration was delineated on cross-sectional anterior segment optical coherence tomography imaging.

The placement of compression sutures near the scleral flap may create upward tension that we hypothesize can lead to subsequent corneal intrastromal deposition. Despite this rare complication, compression sutures remain a good option for the treatment of an overfiltering bleb.