Treatment of Choroidal Detachment After Trabeculectomy.

Ahn, Myung Douk; Chung, Jin

Original Article

Journal of the Korean Ophthalmological Society 1992;33(4):401-409.
Published online April 1, 1992.

Treatment of Choroidal Detachment After Trabeculectomy.

Myung Douk Ahn, Jin Chung

Department of Ophthalmology, Catholic University Medical College Kangnam St. Mary's Hospital, Seoul, Korea.

섬유주절제술후 발생한 맥락막박리에 대한 치료

안명덕(Myung Douk Ahn),정진(Jin Chung)

Abstract

Choroidal detachment has frequently been found to be a complication following trabeculectomy. However there remain many controversies about the indication and the timing as to when to perform choroidal drainage. Of 131 cases of trabeculectomy from July 1990 to to June 1991 choroidal detachment was developed in 5 eyes of 4 patients with glaucoma. Among them, 2 cases were treated medically and 3 cases surgically. We classified anterior chamber depth according to grading system and made it the guideline for treatment. As choroidal detachment developed, we used medical therapy including more frequent topical application of cycloplegics and steroids, and observed anterior chamber reformation. When grade III anterior chamber the situation where central cornea touches on lens surface persisted 12 to 24 hours, we performed anterior chamber reformation, sclerotomy and choroidal drainage During the follow-up period (mean, 7 months), all cases except one were controlled without medication, but 1 case developed hypermature cataract 1 month after choroidal drainage, with increased intraocular pressure and conjunctival bleb disappeared. Once choroidal detachment develops, rapid medical treatment is necessary. If medical therapy fails, prompt surgical reformation of the anterior chamber along with drainage of any suprachoroidal fluid is needed in grade Ill anterior chamber.

Key Words: Choroidal detachment;Grading system;Choroidal drainage;Hypermature cataract