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Updated: May 21, 2026
05:05
Ultrasound Cyclo Plasty in Eyes with Glaucoma
Published on: January 26, 2018
[Glaucoma attack following Hughes tarsoconjunctival flap: what should be done?]
E Bertelmann1, N Minko, N Torun
1Augenklinik, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Deutschland. Eckart.Bertelmann@charite.de
Summary
Acute glaucoma can occur in a sutured, closed eye after lower eyelid reconstruction using the Hughes tarsoconjunctival flap technique. Early recognition and treatment are crucial for managing this rare complication.
Area of Science:
- Ophthalmology
- Oculoplastic Surgery
Background:
- Lower eyelid reconstruction using the Hughes tarsoconjunctival flap technique is a common procedure for lower eyelid defects.
- Acute glaucoma is a sudden increase in intraocular pressure that can lead to vision loss if not treated promptly.
Observation:
- A patient developed acute glaucoma in the contralateral eye 10 days after lower eyelid reconstruction.
- The patient later experienced a relapse of acute glaucoma in the reconstructed (closed) eye.
- Intraocular pressure (IOP) measurement was challenging due to the sutured eyelids.
Findings:
- This case represents the first reported instance of acute glaucoma occurring in a sutured, closed eye following Hughes tarsoconjunctival flap reconstruction.
- Successful treatment involved medical management (mannitol, acetazolamide) and iridotomy for the initial episode.
- The second episode in the closed eye also responded to medical management, preventing premature eyelid opening.
Implications:
- The risk of developing acute glaucoma should be discussed during the informed consent process for patients undergoing this surgical technique.
- This case highlights the need for improved methods for transpalpebral intraocular pressure measurement in specific clinical scenarios.
- Oculoplastic surgeons should maintain a high index of suspicion for acute glaucoma in patients presenting with eye pain and headache post-reconstruction.
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