Laser trabecular sclerosis for chronic hypotony after vitreoretinal surgery.

PURPOSE: To perform a pilot study of laser trabecular sclerosis (LTS) for chronic ocular hypotony after vitreoretinal surgery.

DESIGN: Prospective noncomparative case series.

PARTICIPANTS: Three patients with chronic hypotony after vitreoretinal procedures underwent LTS. All patients had undergone complex vitreoretinal surgery with attached retinas postoperatively but with persistent hypotony and poor vision.

INTERVENTION: Laser trabecular sclerosis was performed in a fashion similar to laser trabeculoplasty, using a 100-microm spot, 800 to 1000 mW power at 0.1 seconds, and applying heavy confluent treatment in >/=1 sessions throughout the angle where trabecular meshwork was visible.

MAIN OUTCOME MEASURES: Intraocular pressure (IOP), best spectacle-corrected visual acuity, and complications were studied.

RESULTS: In 1 patient, a single session of LTS was followed by an increase in IOP of approximately 4 mm, with subjective and objective improvement in vision. A second patient exhibited improvement in IOP and visual acuity after 3 sessions of LTS. A third patient underwent 3 sessions of LTS without improvement in IOP or vision.

CONCLUSION: Given the limitations of this small series, including the lack of a randomized prospective design, it is not possible to determine the safety or efficacy of LTS, but this study does suggest that this procedure could play a therapeutic role in some patients with chronic symptomatic hypotony after complex intraocular surgery. Further study is warranted.