Hypotony after trabeculectomy: don't stop anti-inflammatory drops & don't operate if post-op care inadequate.
/The trabeculectomy involves creating a trap-door in the sclera underneath the upper lid. The goal of the follow-up care is basically to make sure that this trap door never heals properly so that it is leaking out a small amount of aqueous humour to the overlying conjunctival layer to lower the pressure inside the eye. It is vital that aggressive anti-inflammatory treatment be maintained in the early post-operative period to prevent proper healing. Unfortunately, sometimes my colleagues alter the originally planned post-operative regiment of aggressive steroid drops when they encounter too low a pressure or a shallow anterior chamber and jeopardize the chance of longterm success.
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