A randomized prospective study comparing trabeculectomy with and without the use of a new removable suture.
BACKGROUND
The aim of this prospective study is to verify, in terms of both early postoperative complications and intraocular pressure (IOP) outcomes, the performance of a scleral flap removable suture.


METHODS
Sixty-six patients that underwent trabeculectomy were randomly divided into two groups: in the first group (group A, 33 eyes) a standard fornix-based trabeculectomy was performed by using a conjunctival chain suture. In the second group (group B, 33 eyes) the same technique was performed with the additional employment of a new removable suture to the scleral flap. The patients were followed-up for 12 months.


RESULTS
After 1 year the mean IOP was 16.58 mmHg (+/-3.73 mmHg) in group A, and 16.12 mmHg (+/-4.21 mmHg) in group B; statistical analysis did not show significant differences between the two groups (P = 0.19). Early postoperative hypotony and shallowing of the anterior chamber were significantly more frequent after standard trabeculectomy than after trabeculectomy using the removable suture (P < 0.02).


CONCLUSIONS
The employment of a fornix-based conjunctival chain suture for the flap allows the use of the removable scleral flap suture, which has proved very effective in preventing insufficient flap resistance with aqueous overdrainage and hypotony, and which is also easy to apply and to remove. Compared with standard trabeculectomy, this device has proved to have similar IOP-lowering efficacy, together with a lower rate of early postoperative complications.
Department of Ophthalmology and Neurosurgery, University of Siena, 53100 Siena, Italy.
A
A
Caporossi
A
A
Balestrazzi
A
A
Malandrini
G M
GM
Tosi
T
T
Caporossi
P
P
Frezzotti
Luca
L
Lomurno
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000473:pathology; D005260:Female; D005902:Glaucoma, Open-Angle / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D015814:Ocular Hypotension / Q000209:etiology; D011183:Postoperative Complications; D011184:Postoperative Period; D012590:Sclera / Q000601:surgery; D013524:Surgical Flaps / Q000473:pathology; D013536:Suture Techniques; D014130:Trabeculectomy / Q000295:instrumentation* / Q000379:methods*