pupil and iris change after glaucoma surgery

[wombat1900]

My mother had a bleb put in about 1.5 weeks ago.  Her iris looks darker and the pupil looks misshapen. She had 20/20 vision before the surgery and now she can barely see the large "E" on the chart.  Light bothers her as well.  It has been leaking since day one. They put the contact bandage on it but it is still leaking.  Her pressure was at 47 and the doctor squeezed the eyeball down to pressure of 10. She is also seeing a dark spot on the side of her vision. Any insight would help easy the stress would be helpful

[wombat1900]

Seems like her pressure is down to 6 from 47.  She still has leaking, They put another bandage on it until next week.  There is a small hole in the bleb. What causes this so soon after surgery?  They increased the dosage of prednisone drops .  What does that do for the leak?

[Doreen Fazio, M.D.]

After trabeculectomy surgery which creates a superior filtering bleb to control the glaucoma, the iris (the colored part of the eye) may look different due to the superior peripheral iridectomy:  a piece of the iris is removed surgically to prevent it from blocking the opening created to drain the eye fluid.  Also the pupil may be dilated with Atropine after the operation to try to keep the front chamber deep.  It is very normal for the vision to be worse after surgery, especially if the eye pressure is low due to a leak.  When the pressure is low, there may be a choroidal, or a swelling of the vascular layer under the retina; this will appear as a shadow to the side.  Once the leak seals, either with the bandage lens or with suturing, the vision should improve, the eye pressure will come up a bit, and the choroidal will resolve.