Prevention of hyphema following trabeculotomy Hiroshi Kobayashi 1 1Department of Ophthalmology, Kanmon Medical Center NHO pp.1551-1558
Published Date 2016/10/15
DOI https://doi.org/10.11477/mf.1410211975
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Abstract Purpose: To report the outcome of trabeculotomy with intraoperative use of viscoelastic material to prevent hyphema.

Cases and Method: This study was made on 85 eyes of 85 patients who received trabeculotomy for primary open-angle glaucoma. The series comprised 47 males and 38 females. The age averaged 68.8±8.2 years. Thirty-nine patients, who underwent surgery prior to January 2009, received conventional trabeculotomy. Forth-five patients, who underwent surgery later, received additional procedure to prevent hyphema by filling the anterior chamber with viscoelastic material before in-rotation of trabeculotome. The viscoelastic material was removed after suturing the scleral flap. Patients were followed up for 12 months.

Results: Intraocular pressure(IOP)averaged 25.7±2.8 mmHg in the conventional group and 25.2±2.0 mmHg in the viscoelastic group. IOP 12 months after surgery averaged 15.3±2.9 mmHg and 15.0±2.9 mmHg respectively. The differences were not significant. Anterior chamber hemorrhage developed in all eyes in both groups immediately after surgery. On the day after surgery, hyphema measuring 1 mm or more was present in all the 39 eyes that received conventional surgery and 6 eyes in the viscoelastic group. Hyphema disappeared after 6.6±2.9 days in the conventional group and 2.0±2.7 days in the viscoelastic group. The difference was significant(p<0.0001). Postoperative IOP spike developed in 6 eyes(15%)in the conventional group and in 2 eyes(4%)in viscoelastic group(p=0.0201).

Conclusion: Use of viscoelastic material during trabeculotomy resulted in significant decrease of postoperative hyphema and IOP spike.

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