Treatment of Chronic Postfiltration Hypotony by Intrableb Injection of Autologous Blood

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Abstract
• Objective. —To treat chronic hypotony with decreased vision after filtration surgery. Design. —After observation from 31/2 to 13 months with no spontaneous improvement, eyes were treated with the experimental therapy and followed up closely to determine the results. Patients. —Four eyes with chronic hypotony, selected from a series of 125 eyes receiving trabeculectomy augmented by intraoperative mitomycin. All eyes had posterior chamber pseudophakia. All eyes had postoperative laser cutting of sutures holding the scleral flap of the trabeculectomy. Intervention. —After administration of topical prophylactic 0.3% ciprofloxacin hydrochloride and topical anesthetic, the bleb was inflated with whole autologous blood through a 27-gauge needle passed subconjunctivally into the bleb. Main Outcome Measures. —Change in intraocular pressure, change in vision, change in choroidal detachment, any type of complication. Results. —Average intraocular pressure increased from 5.5 to 8.2 mm Hg. Average vision improved from 20/148 to 20/33. In two eyes with choroidal detachment, the detachment absorbed in one eye and decreased in the other. No complications occurred. Conclusion. —Intrableb injection of autologous blood deserves further study as a possible treatment for hypotony following filtration.