Abstract

Wound exploration for post-trabeculectomy shallow anterior chamber (AC ) with hypotony often brings unexpected surprises. This video demonstrates a step by step evaluation to find the exact cause of hypotony and correct the same with the least possible collateral damage. Case1- Postoperative day (POD)1 ,low IOP, Grade 4 shallow AC, Seidels positive at 12’o clock position. BCL and cycloplegics tried following which wound exploration planned. Intra operative Seidel’s showed active leak at corneal traction suture site .10’O nylon suture placed.Cheese wiring of scleral flap noted,scleral patch graft placed. Post operative vision was 6/9 with negative Seidel’s.Case2 – Pain and defective vision for 2 days, POD 15 uneventful trabeculectomy with MSICS .Vision5/60,diffuse bleb, Seidel’s negative,Grade4 shallow AC. Gonioscopy revealed iris in scleral tunnel.Simcoe cannula used to manipulate iris away from scleral tunnel. AC formed with no further intervention