Cysts of Tenon's capsule following filtration surgery

Hypertrophy of Tenon's capsule resembling a cyst and recurrence of increased intraocular pressures occurred shortly after glaucoma filtration surgery in eight patients on whom a variety of surgical techniques had been used. Preoperatively, the patients generally had secondary glaucomas with intraocular pressures exceeding 40 mm Hg. The cysts of Tenon's capsule were uniformly localized to the filtration site and were dome-shaped and hard. They were associated with intraocular pressures near the preoperative levels. Three patients were successfully treated with corticosteroids and massage. The others required surgical intervention to restore adequate filtration. Prompt recognition of a Tenon's capsule cyst and appropriate management can restore function to an otherwise failing filtration bleb.