Hypotony is a common complication when filtration surgery is augmented with antimetabolites.1 Autologous blood injection into filtering blebs has been reported to raise the intraocular pressure (IOP) in some patients with chronic postoperative hypotony.2 Herein I describe a patient who had a dangerous IOP elevation following blood injection combined with the instillation of hyaluronate sodium into the anterior chamber.
Report of a Case.
A 40-year-old white man had advanced glaucoma. His condition was worsening while receiving maximal tolerated medical therapy and he had previously undergone laser trabeculoplasty. His visual acuity with −2.50-diopter lenses was 20/20 OU. Results of slit-lamp and gonioscopic examinations were normal. His IOPs were 25 mm Hg in the right eye and 19 mm Hg in the left. There were arcuate scotomas in both eyes, which threatened fixation in the left eye. Cup-to-disc ratios were ≥0.9 in both eyes.The patient underwent a trabeculectomy in
Alward WLM. Marked Intraocular Pressure Rise Following Blood Injection Into a Filtering Bleb. Arch Ophthalmol. 1995;113(10):1232-1233. doi:10.1001/archopht.1995.01100100020013