Rare Complication after Sclero-Trabeculectomy Performed in an Eye with Advanced Primary Open Angle Glaucoma Nonresponsive to Topical Medication

We report the case of a 64 year old woman with advanced, unilateral primary open angle glaucoma for which sclerotrabeculectomy was performed without complications. Five days after surgery the bleb was flat and the intraocular pressure (IOP) was 30 mmHg. Mild massage was indicated. Two days later she presented with flat anterior chamber (AC), IOP 26 mmHg and choroidal detachment that hadn’t resolved despite topical atropine and discontinuation of the massage. We suspected an opening of the subchoroidal space at the site of sclerotrabeculectomy with acces of the aqueous humor (AH) from the AC under the choroid. Drainage of the AH from the subchoroidal space was performed, but with fast reformation of the detachments. Then drainage and cryoapplications at the site of sclerotrabeculectomy were done with temporary good results. Two months later, redrainage, broader cryoapplications and phacoemulsification with IOL implantation were performed with good long term results. 

Keywords: open angle glaucoma; sclero-trabeculectomy; choroidal detachments.