Topical Dorzolamide-lnduced Hypotony and Ciliochoroidal Detachment in Patients With Previous Filtration Surgery

Abstract

We describe 2 patients who have undergone glaucoma filtration surgery in whom delayed hypotony and ciliochoroidal detachment developed following treatment with topical dorzolamide hydrochloride, 2%. Report of Cases. Case 1. A 76-year-old woman was examined 9 months after undergoing cataract extraction combined with trabeculectomy in the right eye. Her intraocular pressure was 31 mm Hg. Biomicroscopy revealed a thin flat bleb and a deep and quiet anterior chamber. Apraclonidine hydrochloride, 0.5%, was prescribed for the patient. Her intraocular pressure stabilized at 18 mm Hg, but further intraocular pressure reduction was indicated and dorzolamide hydrochloride, 2%, was prescribed. Two weeks later, the patient described having a 6-day history of decreased vision and pain in her right eye. An examination revealed a reduction of visual acuity from 20/70 to counting fingers. The intraocular pressure was 5 mm Hg. The conjunctiva was 3+ injected with a flat, Seidel-negative bleb. The anterior chamber was