Uso de sangre autóloga para el tratamiento de hipotonía por ampollas hiperfiltrantes postrabeculectomía

Abstract

Objective: To evaluate the efficacy of topical autologous blood injection in hyperfiltering blebs after trabeculectomy as a treatment for hypotony.

Methods: A retrospective case series of patients who underwent trabeculectomy with mitomycin C, from 2018 through 2021 in Centro Médico Oftalmológico IOFA, who developed ocular hypotony because of hyperfiltering blebs and were treated with topical autologous blood application. The main parameters to evaluate were: intraocular pressure, visual acuity, number of applications, perform additional limitations with sutures, as well as possible complications.

Results: 10 eyes of 9 patients were included in the study. Mean basal IOP was 5,1 ± 0,8 mmHg (4-6), and increased with a statistically significant difference (p<0,001), per month to 8,2 ± 1,3 mmHg (6-10) and pear year to 9,3 ± 1,2 mmHg (7-10), while the mean visual acuity remained statistically unchanged in pretreatment 0,47 ± 0,3 (0,05-0,9), and 0,5 ± 0,3 (0,05-0,9) per year. Half of the patients were able to control the IOP with the autologous blood application (only one application in 4 eyes, two applications in 1 eye). In the rest, it was also necessary to perform the bleb limitation with sutures to control hypotony. Two eyes had hyphema which resolved spontaneously.

Conclusions: The autologous blood application proved to be useful in half of the cases, without significant complications. In the other half, it was necessary to limit with sutures the bleb.