Hypotony Keratopathy Following Trabeculectomy.

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Corneal Disease

Background:

• Trabeculectomy with mitomycin C (MMC) is a common glaucoma surgery.
• Hypotony, or low intraocular pressure (IOP), can lead to complications.
• Corneal decompensation following hypotony is a recognized but poorly understood issue.

Purpose of the Study:

• To evaluate corneal decompensation in patients after trabeculectomy with adjuvant MMC.
• To propose and define "hypotony keratopathy" as a descriptive term for this complication.

Main Methods:

• Retrospective single-center study of 14 eyes from 12 patients.
• Inclusion criteria: trabeculectomy with MMC, concurrent hypotony, and corneal decompensation (Descemet folds or edema).
• Outcome measures: visual acuity, IOP, central corneal thickness, and treatment outcomes.

Main Results:

• Hypotony keratopathy diagnosed an average of 7.5 years post-trabeculectomy.
• Corneal decompensation ranged from mild Descemet folds to significant edema.
• Lower IOP correlated with increased corneal thickness; vision improved with IOP-raising interventions.

Conclusions:

• Hypotony keratopathy is a potentially treatable complication of trabeculectomy with MMC.
• Endothelial dysfunction secondary to hypotony may cause hypotony keratopathy.
• Increasing IOP is crucial for successful treatment and visual recovery.