Abstract
Purpose To evaluate the surgical outcome in terms of intraocular pressure (IOP) control and safety of procedure using a sutureless scleral tunnel technique in patients with uncontrolled glaucoma. Materials and methods This was a prospective, consecutive, noncomparative interventional case series of patients undergoing trabeculectomy. The study was conducted on 19 eyes of 19 patients with medically uncontrolled glaucoma. All of the patients underwent sutureless scleral tunnel trabeculectomy and were followed for 6 months. Patient data such as sex, age, IOP, LogMAR visual acuity (LogMAR VA), antiglaucoma medications, intraoperative and postoperative complications, bleb morphology, and success rate were collected and statistically analyzed. Results Two patients were excluded because of defaulted follow-up. Mean age was 60.58 (±15.14) years, and 65% of the patients were male. Before intervention mean IOP was 29.29 (±8.22) mmHg, and mean number of antiglaucoma medications was 2.05 (±0.89). Six months after intervention, mean IOP was 15.00 (±3.82) mmHg (P < 0.001), mean number of antiglaucoma medications was 0.52 (±1.06) (P < 0.001), complete success rate was 65%, and qualified success rate was 23%. Five patients (29.4%) needed adjunctive needling bleb revision. No major intraoperative complications were encountered. Only four patients (23.5%) had microscopic hyphema and three patients (18%) had flat anterior chamber (grade I) in the immediate postoperative period that managed medically. All but four had shallow and diffuse blebs at last follow-up. Conclusion It appears that sutureless scleral tunnel trabeculectomy is a safe and effective drainage procedure for treating uncontrolled glaucoma. Larger-scale study is recommended.
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References
Cairns JE (1968) Trabeculectomy. Preliminary report of a new method. Am J Ophthalmol 66:673–679
Watson PG, Jakeman C, Ozturk M, Barnett MF, Barnett F, Khaw KT (1990) The complications of trabeculectomy (a 20-year follow-up). Eye 4(Pt 3):425–438
Berke SJ, Bellows AR, Shingleton BJ et al (1987) Chronic and recurrent choroidal detachment after glaucoma filtering surgery. Ophthalmology 94:154–162
Rahman A, Mendonca M, Simmons RB et al (2000) Hypotony after glaucoma filtration surgery. Int Ophthalmol Clin 40:127–136
Raina UK, Tuli D, Mehta DK (1999) Polyglactin sutures versus nylon sutures for scleral flap suturing in trabeculectomy. Ophthalmic Surg Lasers 30:554–559
Edmunds B, Thompson JR, Salmon JF et al (2001) The National Survey of Trabeculectomy. II. Variations in operative technique and outcome. Eye 15(Pt 4):441–448
Stalmans I, Gillis A, Lafaut AS, Zeyen T (2006) Safe trabeculectomy technique: long term outcome. Br J Ophthalmol 90:44–47
Simsek T, Citirik M, Batman A, Mutevelli S, Zilelioglu O (2005) Efficacy and complications of releasable suture trabeculectomy and standard trabeculectomy. Int Ophthalmol 26:9–14
Ashraff NN, Wells AP (2005) Transconjunctival suture adjustment for initial intraocular pressure control after trabeculectomy. J Glaucoma 14:435–440
Prevezas DC, Melissurgos ID (1997) Adjustable temporal suture in trabeculectomy with scleral flap. Ophthalmic Surg Lasers 28:745–750
Zohdy GA, Lukaris A, Rogers ZA, Hill A, Roberts-Harry TJ (1998–1999) Early results of punch trabeculectomy. Int Ophthalmol 22:253–256
Ophir A, Pikkel J (2001) Mini-trabeculectomy in eyes with high risk of scarring: midterm follow-up. Am J Ophthalmol 131:13–18
Thimmarayan SK, Rao VA, Gupta A (2006) Mini-trabeculectomy in comparison to conventional trabeculectomy in primary open angle glaucoma. Eur J Ophthalmol 16:674–679
Ophir A (2001) Mini-trabeculectomy as initial surgery for medically uncontrolled glaucoma. Am J Ophthalmol 132:229–234
Gous PN, Roux P (1995) Preliminary report of sutureless phacotrabeculectomy through a modified self-sealing scleral tunnel incision. J Cataract Refract Surg 21:160–169
Vuori ML, Viitanen T (2001) “Scleral tunnel incision”—trabeculectomy with one releasable suture. Acta Ophthalmol Scand 79:301–304
Lai JS, Lam DS (1999) Trabeculectomy using a sutureless scleral tunnel technique: a preliminary study. J Glaucoma 8:188–192
Wells AP, Bunce C, Khaw PT (2004) Flap and suture manipulation after trabeculectomy with adjustable sutures: titration of flow and intraocular pressure in guarded filtration surgery. J Glaucoma 13:400–406
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Eslami, Y., Fakhraie, G., Amini, H. et al. The results of trabeculectomy using a sutureless scleral tunnel technique. Int Ophthalmol 29, 329–332 (2009). https://doi.org/10.1007/s10792-008-9240-4
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DOI: https://doi.org/10.1007/s10792-008-9240-4