Occult wound leak diagnosed by ultrasound biomicroscopy in patients with postoperative hypotony.
OBJECTIVE
To describe the ability of high-frequency ultrasound biomicroscopy (UBM) to diagnose occult wound leaks as a cause for hypotony after cataract surgery.


METHODS
Six patients with persistent hypotony after cataract surgery were sent for UBM examination. Slitlamp examination and gonioscopy of the 6 eyes had not revealed a cause for the hypotony.


RESULTS
Ultrasound biomicroscopy showed subtle wound separation with shallow conjunctival elevation at the site of the cataract wound in the 6 patients. Two eyes had surgical repair of the subconjunctival wound leak, and the other 4 were treated medically. In the 2 eyes with surgically repaired wounds, the hypotony cleared after wound closure. Of the 4 medically treated eyes, hypotony resolved in 2 and 1 had a recurrence of hypotony. The other 2 eyes had fluctuating intraocular pressure for an extended period.


CONCLUSIONS
Hypotony after cataract surgery occurred in 6 eyes due to subtle wound leaks difficult to detect by clinical observation. Ultrasound biomicroscopy can be a helpful aid to clinical examination in detecting these leaks.
Sicco thoe Schwartzenberg
G W
GW
Department of Ophthalmology, Ontario Cancer Institute, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada.
Pavlin
C J
CJ
D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment / Q000000981:diagnostic imaging*; D005260:Female; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D015814:Ocular Hypotension / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D013529:Surgical Wound Dehiscence / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D014463:Ultrasonography; D014945:Wound Healing