The Difficulties of Trabeculectomy in a Primary Angle-Closure Glaucoma Patient

• Main Authors: Herdina Ramadhani, -, Nurwasis, -, Yulia Primitasari, -, Evelyn Komaratih, Evelyn
• Format: Article PeerReviewed
• Language: English; Indonesian; English
• Published: Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga
• Subjects: R5-920 Medicine (General)
• Online Access: https://repository.unair.ac.id/127063/1/19.%20The%20Difficulties%20of%20Trabeculectomy_compressed.pdf; https://repository.unair.ac.id/127063/2/19.pdf; https://repository.unair.ac.id/127063/3/19.%20The%20Difficulties%20of%20Trabeculectomy%20in%20a%20Primary%20Angle-Closure.pdf; https://repository.unair.ac.id/127063/; https://ojs2.e-journal.unair.ac.id/VSEHJ/article/view/28694; https://doi.org/10.20473/vsehj.v1i2.2022.38-44
• Institution: Universitas Airlangga

Introduction: Trabeculectomy is an incisional surgery for glaucoma patient. Performing trabeculectomy in primary angle-closure glaucoma (PACG) is quite difficult. Caution is needed for the occurrence of flat anterior chamber (FAC) and malignant glaucoma. We present a case management of trabeculectomy in a PACG patient. Case presentation: A 52-year-old male had blurred vision in his left eye since one year ago. The patient felt left visual field narrowing since eight months ago. Patient had type 2 diabetes mellitus. Visual acuity on the left eye was 5/7.5. Intraocular pressure (IOP) increased (29 mmHg). Gonioscopy showed closed angle and peripheral anterior synechiae. Glaucomatous optic neuropathy was found with C/D ratio value of 0.9 and superior-inferior RNFL thinning on optical coherence tomography (OCT). Anterior segment OCT revealed shallow anterior chamber depth (ACD) 2.54 mm. The right eye visual acuity was 5/5, normal IOP, and shallow ACD (2.66 mm). Patient was underwent left eye trabeculectomy. Postoperatively, left eye anterior chamber and bleb were formed. He had normal IOP without glaucoma medications. Conclusions: Trabeculectomy is a surgical procedure for glaucoma. Close monitoring is required to avoid the risk of postoperative FAC and malignant glaucoma in PACG.