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  • Title: Role of trabeculectomy in the management of hypertensive traumatic total hyphaema.
    Author: Baig MS, Ahmed J, Ali MA.
    Journal: J Coll Physicians Surg Pak; 2009 Aug; 19(8):496-9. PubMed ID: 19651012.
    Abstract:
    OBJECTIVE: To assess the visual outcome and complications after trabeculectomy in patients of hypertensive traumatic total hyphaema. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Department of Ophthalmology, Dow University of Health Sciences, Karachi, from June 2004 to May 2008. METHODOLOGY: Patients with total hyphaema admitted in eye ward were included. Socio-demographic data was recorded. Complete ophthalmic examination and B-scan ultrasonography were undertaken. Trabeculectomy was performed. Visual outcome, intraocular pressure reduction and complications were recorded. Descriptive statistics were calculated. RESULTS: Twenty two patients underwent trabeculectomy with mean age was 23.18 +/- 12.67 years. Male to female ratio was 3.26:1. Toy gun pellet injury was present in 6 (27.3%) cases. The average intraocular pressure before surgery was 40.86 mm of Hg. All the patients had a visual acuity of light perception with an accurate projection. Evidence of corneal blood staining was observed in 16 (72.7%) patients. Mean intraocular pressure at last follow-up was 15.1 +/- 2.11 mm of Hg with a minimum of 12 mm and maximum of 20 mm of Hg in 19 (86.3%) patients (complete success). Three patients were on additional anti-glaucoma medications. Filtering bleb was functional in only 4 (18.2%) patients. Visual acuity was 6/18 or better in 18 (81.8%) patients at last follow-up. CONCLUSION: Trabeculectomy was a satisfactory procedure for traumatic hyphaema for restoring good vision, if undertaken earlier. This procedure is not associated with significant complications and is very useful in reducing raised intraocular pressure.
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