24F; Alloflo surgery resulted in hypotony. Need help advocating next steps
My daughter has had many surgeries in effort to get IOP's under control. These include Ahmed valve/tubes both eyes. Her right eye is most Glaucoma damaged with 70+% vision loss. With IOP back in the 30's several months ago, her surgeon did an Alloflo procedure. There were some complications with post-surgery IOP of 7 and blurry vision, then high spikes from steroid, and vision recovered. But that eye has, so far, successfully settled back down in the 12-15's consistently now.
Her left eye without significant damage was also running 30's. The same Alloflo procedure was performed and resulted in 4 IOP post-surgery. Expecting some recovery and steroid influence it has now been 5 weeks with consistent 4-5 readings from her home and office tonometer. Her vision is blurry and severely affected.
I am concerned as time is of the essences now. Her surgeon is an excellent surgeon, but I can tell he didn't expect this. His next plan is to cap off the Ahmed tube and is now tapering the steroid off more rapidly. I expect he is actually hoping for some scaring to reduce Alloflo filtering now that there is no steroid effect raising IOP. But I'm not sure if it makes sense.
Her pressures were in the 30's with Ahmed tubes and 4 immediately after Allflo, so I'm not sure if capping off the Ahmed tube is going to make much of a difference. And the situation, of course, is urgent.
What questions should I ask or actions should I advocate for? What procedures or medications may help raise IOP out of hypotony to a 10-12 or so target? I'm mainly looking for options and knowledge to help us communicate and discuss options logically and intelligently next week.
Posted Aug 12, 2026, 3:32 AM UTC