Role of trabeculectomy in the management of hypertensive traumatic total hyphaema.

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.