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Trabeculectomy for traumatic hyphema with increased intraocular pressure
T A Graul1, M S Ruttum, M A Lloyd
1Department of Ophthalmology, Medical College of Wisconsin, Milwaukee.
American Journal of Ophthalmology
|February 15, 1994
Summary
Trabeculectomy with anterior chamber washout and peripheral iridectomy effectively lowers intraocular pressure in patients with traumatic hyphema unresponsive to medical management. This surgical approach offers a safe and reliable option for managing complex cases.
Area of Science:
- Ophthalmology
- Surgical Procedures
Background:
- Traumatic hyphema unresponsive to medical management presents a significant challenge.
- Elevated intraocular pressure (IOP) is a serious complication requiring effective intervention.
Purpose of the Study:
- To evaluate the efficacy and safety of trabeculectomy with anterior chamber washout and peripheral iridectomy for treating medically refractory traumatic hyphema.
- To assess the long-term IOP control and visual outcomes in patients undergoing this surgical procedure.
Main Methods:
- Retrospective review of 11 consecutive patients with traumatic hyphema.
- Surgical intervention included trabeculectomy with anterior chamber washout and peripheral iridectomy.
- Intraocular pressure and visual acuity were monitored postoperatively.
Main Results:
- Preoperative mean IOP was 48 mm Hg; 10/11 patients achieved IOP ≤21 mm Hg postoperatively.
- One patient required additional medical therapy (topical beta-blocker, oral acetazolamide) for IOP control.
- Eight patients achieved visual acuity of 20/60 or better at follow-up (8-97 months).
- Corneal blood staining occurred in eight patients.
Conclusions:
- Trabeculectomy with anterior chamber washout and peripheral iridectomy is a safe and reliable surgical option for traumatic hyphema unresponsive to medical treatment.
- The procedure effectively lowers and maintains intraocular pressure, facilitating blood clearing from the anterior chamber.