Three types of retinal bleeding as a complication of hypotony after trabeculectomy

Although small retinal bleeding has been evaluated as a complication of filtering surgery, long-standing retinal bleeding is rare. We report 3 rare cases of young patients with massive retinal hemorrhages following trabeculectomy with 5-fluorouracil or mitomycin C. The bleeding in 1 case resolved spontaneously, whereas the bleeding in the other 2 cases did not resolve and the visual acuity remained poor. Every patient showed markedly delayed retinal circulation. Possible dysfunction of the retinal blood vessels may be responsible for the development of the other two types of massive bleeding, especially in advanced glaucoma with a total cup disk: one is decompression retinopathy and another central retinal vein occlusion or hemorrhagic retinopathy.