How would you manage this patient? Answer It is important to break the cyst to avoid failed trabeculectomy. As this condition is seen at 3 weeks post-operative. Digital pressure on the lower lid upward may exert sufficient pressure to break the adhesion. Alternatively, pressing the dome with digital pressure or a cotton bud through the upper lid may also disrupt the adhesion. If this failed, needling may be required to rupture the cyst to allow the fluid to escape. In view of this problem, would you routinely excised Tenon's capsule during trabeculectomy? Answer Excision of the Tenon's capsule result in a thinner bleb which is associated with a higher incidence of complication such as bleb leak. If the patient has a high risk for trabeculectomy failure such as black race, young patients or previous trabeculectomy failure; anti-metabolite such as 5-FU or mitomycin can be used. More questions
How would you manage this patient?
In view of this problem, would you routinely excised Tenon's capsule during trabeculectomy?
