case_images: PMC5488070_01
case_images: Thin filtration bleb and chorioretinal folds
case_images: OC-07-15-g-001.jpg
case_images: PMC5488070_01_OC-07-15-g-001.jpg
case_images: F1
case_images: This led to hypotony refractory to conservative measures such as pressure patching, decreased of corticosteroids dosage and use of aqueous suppressants and three weeks after, she developed hypotony maculopathy with low visual acuity (VA = 20/60 OD) (Figure 1 (Fig. 1)).
case_images: Suture of the scleral flap (left) and conjunctival graft (right)
case_images: OC-07-15-g-002.jpg
case_images: PMC5488070_01_OC-07-15-g-002.jpg
case_images: F2
case_images: The result was satisfactory and the hypotony resolved (Figure 2 (Fig. 2)), although, in the early postoperative period, there was a history of minor blunt ocular trauma without further complications.
case_images: Avascular bleb and visualization of the underlying uveal tissue
case_images: OC-07-15-g-003.jpg
case_images: PMC5488070_01_OC-07-15-g-003.jpg
case_images: F3
case_images: On examination, VA OD was 20/200, IOP was 5mm Hg with a thin, avascular and transudative bleb, visualizing the underlying uveal tissue with chorioretinal folds (Figure 3 (Fig. 3)).
case_images: Absence of scleral flap
case_images: OC-07-15-g-004.jpg
case_images: PMC5488070_01_OC-07-15-g-004.jpg
case_images: F4
case_images: During the procedure, it was not possible to identify the scleral flap (Figure 4 (Fig. 4)), so we used 2 layers of Tutopatch  (a collagenous membrane derived from solvent preserved irradiated bovine pericardium) to close the fistula (Figure 5 (Fig. 5)). 
case_images: Tutopatch graft
case_images: OC-07-15-g-005.jpg
case_images: PMC5488070_01_OC-07-15-g-005.jpg
case_images: F5
case_images: During the procedure, it was not possible to identify the scleral flap (Figure 4 (Fig. 4)), so we used 2 layers of Tutopatch  (a collagenous membrane derived from solvent preserved irradiated bovine pericardium) to close the fistula (Figure 5 (Fig. 5)). 
case_images: Conjunctiva over the graft
case_images: OC-07-15-g-006.jpg
case_images: PMC5488070_01_OC-07-15-g-006.jpg
case_images: F6
case_images: After 8 months
case_images: OC-07-15-g-007.jpg
case_images: PMC5488070_01_OC-07-15-g-007.jpg
case_images: F7
case_images: A good clinical evolution occurred and after 2 months, IOP was 15 mmHg without Seidel phenomenon or changes in the fundus and VA was 20/20 OD (Figure 7 (Fig. 7)).