title: External trabeculectomy with T-Flux implant.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of T-Flux implant in nonpenetrating glaucoma surgery.
  
  
  METHODS
  This clinical interventional case series study included 35 eyes of 35 patients with medically uncontrolled primary open angle glaucoma. External trabeculectomy with T-Flux (ETTF) is a technique of nonpenetrating glaucoma surgery, in which after removing deep scleral tissue and un-roofing the canal of Schlemn (CS) the external trabecular tissue is peeled off to enhance the aqueous drainage without opening the anterior chamber. A non-absorbable T-Flux implant (IOL TECH Laboratories, France) was sutured in deep intrascleral space to keep it patent. Snellen's best-corrected visual acuity, slit lamp biomicroscopy, intraocular pressure (IOP), gonioscopy, funduscopy, and optic disc assessment were performed preoperatively and postoperatively at 1 day, 1 week, and 1, 3 , 6, and 12 months. Visual field testing was performed preoperatively and at 6 and 12 months postoperatively.
  
  
  RESULTS
  For three eyes, surgery was converted to standard trabeculectomy owing to the perforation of trabeculo-Descemet's membrane and iris prolapse and excluded from the study. The results of the remaining 32 eyes were included in the study. Preoperative IOP (mean +/- SD) of 32.88 +/- 5.7 mmHg decreased to 15.44 +/- 1.6 mmHg after 12 months. Ten eyes (28.6%) had microhyphema that resolved spontaneously; 3 eyes (8.6%) had microperforation without iris prolapse so ETTF was proceeded routinely. The preoperative number of antiglaucoma medications per patient reduced from (mean +/- SD) 2.74 +/- 0.61 to 0.11 +/- 0.32 postoperatively at 12 months. Visual acuity and visual fields remained stable.
  
  
  CONCLUSIONS
  ETTF appears to provide significant control of IOP and have low incidence of complications.
authors.affiliation: Department of Ophthalmology, Cork University Hospital, Cork--Ireland. sjungkim@hotmail.com
authors.forename: S
authors.initials: S
authors.lastname: Jungkim
authors.forename: S K
authors.initials: SK
authors.lastname: Gibran
authors.forename: K
authors.initials: K
authors.lastname: Khan
authors.forename: A
authors.initials: A
authors.lastname: Murray
mesh_terms: D000328:Adult; D000368:Aged; D001082:Aqueous Humor / Q000378:metabolism; D005260:Female; D020327:Glaucoma Drainage Implants; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D013536:Suture Techniques; D014130:Trabeculectomy / Q000379:methods*; D014792:Visual Acuity; D014794:Visual Fields