Background: Glaucoma is the second leading cause of blindness in sub-Saharan Africa after cataract. The standard treatment is trabeculectomy. However, higher fibroblast activities in Blacks and Asians from more vigorous tissue reactions to trauma including surgical trauma, cause filtering glaucoma procedures to fail more in Blacks than in Caucasians. This report shows the
advantage of microtrephination over trabeculectomy in a Keloid former with glaucoma.
Case Report: One male glaucoma patient had trabeculectomy in the right eye and microtrephination in the left eye at the University of Benin Teaching Hospital, Benin-city, Nigeria. He was not known to be a Keloid former at the time of surgery. Trabeculectomy failed to control the intraocular pressure in the right eye under 6 months and had to be repeated twice before it was discovered that the patient was a keloid former. Microtrephination was able to control and keep the intraocular below 20 mmHg in the other eye (left eye) for at least 2 years before he was lost to follow-up.
Conclusions: Microtrephination may be a more effective procedure than trabeculectomy in controlling intraocular pressure in glaucoma patients who are keloid formers.

Keywords: Glaucoma, microtreplination, Trabeculectomy, keloid