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Abstract

Severe ocular hypotony following trabeculectomy with Mitomycin-C (MMC) is an uncommon but vision-threatening complication that may lead to chorioretinal folds and persistent visual impairment. Management is often challenging, especially when excessive filtration and bleb atrophy are present. Following bilateral trabeculectomies enhanced with MMC, a 59-year-old man with open-angle glaucoma experienced increasing chorioretinal folds and persistent hypotony. Multiple conservative and surgical interventions—including additional scleral flap sutures, cycloplegics, soft contact lens use, and intracameral viscoelastic injection—provided only temporary improvement. Due to persistent overfiltration and bleb thinning, a conjunctival autotransplantation procedure was performed to mechanically reduce filtration. Following surgery, intraocular pressure stabilized between 12–14 mmHg, and visual acuity improved moderately, although chorioretinal folds remained partially unresolved.

Keywords: Trabeculectomy, Mitomycin-C, Hypotony, Conjunctival autotransplantation, Overfiltration, Bleb atrophy

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