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Es zeigte sich eine okul\u00e4re Hypotonie mit Intraokulardruck von 2\u202fmmHg bei prominentem Sickerkissen sowie eine makul\u00e4re F\u00e4ltelung von Netz- und Aderhaut als Ursache der Visusreduktion. Die Diagnose hypotone Makulopathie wurde gestellt. Nach zun\u00e4chst ausbleibender Besserung erfolgte eine Revisionsoperation. Intraoperativ zeigte sich ein sehr d\u00fcnner, zu kleiner Skleradeckel mit ausgerissener Naht sowie eine im Verh\u00e4ltnis zu gro\u00dfe Sklerektomie, was eine suffiziente Nahtrevision unm\u00f6glich machte. Daher wurde die Fistulationsstelle mit einem 5\u202f\u00d7\u20095\u202fmm Lyoplant\u00ae-Implantat (Aesculap, Braun, Melsungen, Deutschland, zellfreies bovines Perikard) abgedeckt und mittels N\u00e4hten fixiert, um die Kammerwasserfiltration kontrolliert zu reduzieren. Der postoperative Verlauf gestaltete sich komplikationslos. Sechs Wochen nach der Revision zeigte sich ein normalisierter Intraokulardruck von 12\u202fmmHg, ein Visusanstieg, sowie eine unauff\u00e4llige Makula in der optischen Koh\u00e4renztomographie. Der Fall verdeutlicht die Bedeutung einer ad\u00e4quaten Gr\u00f6\u00dfe und Dicke des Skleradeckels, insbesondere bei jungen Patienten mit weicherer Sklera, um eine Hyperfiltration und eine hypotone Makulopathie zu vermeiden. Die Abdeckung der Sklerafistel mit bovinem Perikard stellte eine effektive chirurgische Therapieoption dar.<\/jats:p>","DOI":"10.1007\/s00347-026-02398-9","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T14:36:37Z","timestamp":1771338997000},"page":"391-395","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Revision bei Hypotonie nach Trabekulektomie\u00a0\u2013 Besonderheiten bei einem jungen Patienten","Revision for hypotension after trabeculectomy\u2014Specific features in a\u00a0young male patient"],"prefix":"10.1007","volume":"123","author":[{"given":"Nathanael Urs","family":"H\u00e4ner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damian","family":"Jaggi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel-Benjamin","family":"Lincke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Darius","family":"Unterlauft","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"2398_CR1","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1016\/j.ajo.2014.05.021","volume":"158","author":"E Bitrian","year":"2014","unstructured":"Bitrian\u00a0E, Song\u00a0BJ, Caprioli\u00a0J (2014) Bleb revision for resolution of hypotony maculopathy following primary trabeculectomy. 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F\u00fcr die aufgef\u00fchrten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. F\u00fcr Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, \u00fcber die Patient\/-innen zu identifizieren sind, liegt von ihnen und\/oder ihren gesetzlichen Vertretern\/Vertreterinnen eine schriftliche Einwilligung vor.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Einhaltung ethischer Richtlinien"}}]}}