How is aqueous flow decreased following trabeculectomy?

Updated: May 18, 2020
  • Author: Maria Hannah Pia Uyloan de Guzman, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Answer

Answer

Decreasing aqueous flow

The postoperative IOP may be low due to excessive flow of aqueous through the trabeculectomy site or due to ciliary body hyposecretion. Possible indicators of excessive flow are a very high and/or very diffuse bleb and a shallow anterior chamber. However, the bleb may be low if there is an associated bleb or wound leak and the anterior chamber may be normal in depth. Conservative management of excessive flow (whether the excessive flow is through the scleral flap to the subconjunctival space, through a bleb or wound leak to outside the eye, or both) includes reducing the anti-inflammatory treatment to allow some scarring and external tamponade using a large diameter contact lens, a Simmons shell, or patching. If conservative measures fail or are inadequate, flap and/or conjunctival sutures can be added or revised, but this additional surgery increases the risk of bleb failure.


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