Ocular Hypotony after Baervaeld Shunt Implantation for Glaucoma

We are reporting a case of a 61 years old, male patient, with refractory glaucoma, who underwent uneventful Baervaeldt shunt implantation in the left eye. The eye was stable on antiglaucomatous therapy after surgery. He developed almost flat anterior chamber on the ninth postoperative day. Injection of air and balanced salt solution (BSS) in the anterior chamber was performed. The patient came back the next day, in the same situation, with almost flat anterior chamber. Injection of Sodium Hyaluronate in the anterior chamber was performed, hoping that the flow through the shunt would stabilize. The next day, the anterior chamber was flat. Opening of the conjunctiva and ligation of the tube with a new suture (8-0 Vicryl) was performed. The anterior chamber stabilized after this third intervention. There are specific measures that should be taken to prevent hypotony after Baervaeldt shunt implantation, especially in patients predisposed for postoperative hypotony. Immediate intervention is necessary in cases of extreme hypotony where preservation of the globe is threatened.