The results of trabeculectomy using a sutureless scleral tunnel technique.
OBJECTIVE
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.


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.


CONCLUSIONS
It appears that sutureless scleral tunnel trabeculectomy is a safe and effective drainage procedure for treating uncontrolled glaucoma. Larger-scale study is recommended.
Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Medical Sciences, Tehran University, Qazvin Square, Tehran, Iran.
Yadollah
Y
Eslami
Ghasem
G
Fakhraie
Heidar
H
Amini
Reza
R
Zarei
Sasan
S
Moghimi
Mohammad Taher
MT
Rajabi
Reza
R
Ghaffari
D000368:Aged; D005260:Female; D005901:Glaucoma / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D012086:Reoperation; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques; D014130:Trabeculectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome