Early post-operative pressure rise with ciliary body incarceration into Watson type trabeculectomy fistula

We studied six patients with early failure after Watson's trabeculectomy done due to chronic simple, neovascular, or chronic angle-closure glaucoma. After operation the eyes showed a maximum intraocular pressure (IOP) between 50 mmHg and 66 mmHg and no filtering bleb. Reoperation on the 5th to 14th post-operative day showed incarceration of ciliary body into the trabeculectomy fistula in all cases. The uveal protrusion was replaced and a deep corneoscleral block was removed in front of the scleral spur in three cases, and electrocoagulation of the anterior edges of the trabeculectomy fistula was done in other three cases. After a 4 months to 1.5 years follow-up IOP was 12 mmHg to 18 mmHg and only two eyes needed medical therapy. The results suggest that trabeculectomy in front of the scleral spur is indicated to avoid incarceration of the ciliary body into the trabeculectomy fistula.