Publication: Effectiveness of combination of permanent and releasable scleral flap sutures in trabeculectomy: A randomized clinical trial
Date
2006
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Introduction: Trabeculectomy is a commonly used surgical treatment for glaucoma.
Purpose: To evaluate the effectiveness of combination of permanent and releasable scleral flap sutures to minimize
the immediate postoperative complications of trabeculectomy.
Materials and methods: This study was carried out in Department of Ophthalmology, B P Koirala Institute of
Health Sciences, Dharan, Nepal. Forty one eyes of 34 patients undergoing trabeculectomy were randomized to
undergo either conventional trabeculectomy (Group A= 20 eyes) or trabeculectomy with combination of permanent
and releasable scleral flap sutures (Group B =21 eyes). The parameters studied were intraocular pressure (IOP),
anterior chamber depth (ACD) and surgical complications over a period of 6 weeks.
Results: Significantly higher number of eyes belonging to group A (14 eyes) had shallower anterior chamber than
group B (7 eyes) on first post operative day (p=0.042). Six eyes (30%) in group A had peripheral or central irido-
corneal touch in early postoperative period as compared to only one in Group B. Hypotony was noted in 3 eyes in
each group. Two patients in group A required reformation of anterior chamber. Other surgical complications in the
two groups were similar.
Both the groups had a significant drop in IOP following surgery. However, there was no significant difference in
the IOP between the two groups after 6 weeks (Group A: 10.95 ± 3.03 mmHg vs. Group B: 12.29 ± 4.67 mmHg;
p=0.87). There was a significant drop in IOP following removal of sutures (15.19 ± 6.15 mmHg to 13.19 ± 6.13
mmHg; p=006) in group B.
Conclusion: Use of combination of permanent and releasable scleral flap sutures is a safe technique that
significantly reduces the incidence of immediate postoperative shallow anterior chamber after trabeculectomy.
Key words: Trabeculectomy, Intra ocular pressure, anterior chamber depth, combination of releasable and
permanent scleral flap sutures
Description
Kumari R, Badhu BP, Das H
B. P. Koirala Institute of Health Sciences, Department of Ophthalmology, Dharan, Sunsari, Nepal