Purpose: To describe a modified suturing technique for the treatment of hypotony.
Methods: A prospective case series of 15 patients with hypotony from an overfiltering trabeculectomy underwent full-thickness hypotony sutures. The technique involves placing several radial interrupted 10-0 nylon sutures in the area of the prior trabeculectomy. The suture pass starts at the limbus, travels through the conjunctiva, and full-thickness sclera before exiting the conjunctiva. The sutures were selectively removed postoperatively to titrate the intraocular pressure (IOP). Hypotony resolution, IOP, visual acuity, and complications were assessed on postoperative visits.
Results: Before surgery, the mean IOP was 3.3 mm Hg. The mean IOP 1 day after surgery was 23.5 mm Hg, which settled to 12.9 mm Hg 3 months after surgery. Hypotony was reversed in 100% of patients and 87% achieved a goal IOP. Suture removal was performed in 73%, most within the first week after surgery.
Conclusions: Placing full-thickness hypotony sutures is an effective way to treat ocular hypotony. Sutures can be removed postoperatively to titrate the IOP.