Intracameral viscoelastic treatment for hypotony after glaucoma incisional surgery

We report on a minimally invasive treatment of symptomatic hypotony after glaucoma surgery. Hypotony after incisional glaucoma surgery can have severe visual consequences. Refractory symptomatic hypotony often requires surgical intervention to prevent further vision loss. The clinical records of four patients in this interventional case series with symptomatic hypotony and choroidal detachments after incisional glaucoma surgery between 2013 and 2014 were reviewed. Observations were made as the cases progressed. Visual obscuration secondary to refractory hypotony was treated with an intracameral injection of high-molecular-weight ocular viscoelastic devices (HMWOVD). Postinjection, mean intraocular pressure improved from a baseline of 3.6 mm Hg to 24.0, 15.5, and 9 mm Hg at 1 day, 1 month, and 6 months' post-intervention, respectively. The mean visual acuity after injection improved from 20/274 to 20/83 at 6 months. Choroidal detachments resolved within 1 week in all patients. Intracameral HMWOVD for the treatment of symptomatic hypotony post-incisional glaucoma surgery is minimally invasive, avoided reoperation, and led to quick visual recovery.