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.