Hypotony as a late complication of trabeculectomy

A young man with pigmentary glaucoma was treated successfully by trabeculectomy in one eye. Approximately 13 months later, relatively minor trauma produced hypotony. Despite repeated examinations, the causative factor, a minute wound leak in the filtering bleb, was not detected until the hypotony had been present for six months. During this time, vertical choroidal folds developed in the macular region, associated with a marked loss of central vision. Successful cryogenic repair of the leaking bleb and subsequent normalization of tension was achieved; however, pigmentary changes noted in the macula as induced by the choroidal folds persisted.