To the Editor.
—Profound hypotony following cataract extraction is usually due to wound leak, cyclodialysis cleft, or retinal detachment.1 This case represents an occult form of hypotony from scleral perforation by the superior rectus bridle suture. The diagnosis was made by gonioscopy through the superior sector iridectomy.
Report of a Case.
—An 80-year-old woman with bilateral Fuchs' endothelial dystrophy and a history of cataract extraction of the left eye followed by penetrating keratoplasty underwent cataract extraction of the right eye. The preoperative intraocular pressure was 13 mm Hg. Just before surgery, a Honan balloon was applied to the eye. The superior rectus tendon was grasped with a large-toothed forceps and a 4-0 silk bridle suture was placed. In retrospect, the surgeon recalled that the eye was soft, and some difficulty was encountered in making the scleral groove. This was assumed to be due to the Honan balloon and not
Pederson JE, Cantrill HL. Hypotony From Occult Bridle Suture Perforation. Arch Ophthalmol. 1988;106(5):581-582. doi:10.1001/archopht.1988.01060130631008