Transconjunctival suturing of the scleral flap for overfiltration with hypotony maculopathy after trabeculectomy.
OBJECTIVE
To assess the efficacy of transconjunctival suturing of the scleral flap in improving hypotony maculopathy resulting from overfiltration after trabeculectomy.


METHODS
Retrospective review.


METHODS
35 eyes of 33 patients.


METHODS
Patients underwent transconjunctival scleral flap suturing for hypotony maculopathy following trabeculectomy using mitomycin C. The scleral flap was sutured through the conjunctiva as an outpatient clinic procedure using a spatulated needle with a 10-0 nylon suture.


RESULTS
The average age of the patients was 67.5 (SD 4.80, range 39-83) years, and 52% patients were male. The average duration of hypotony prior to transconjunctival suturing of the flap was 108.0 (SD 68.3) days. The median intraocular pressure (IOP) before suturing was 3 mm Hg, and the median IOP 6 months after the procedure was 9 mm Hg (p < 0.0001). The median best-corrected visual acuity (BCVA) before transconjunctival suturing of the scleral flap was 20/100, and the median BCVA 6 months after the procedure was 20/30 (p < 0.0001). Compared with visual acuity before suturing the average gain in BCVA was 4.9 (SD 0.8) lines.


CONCLUSIONS
Transconjunctival suturing of the trabeculectomy scleral flap is an effective treatment to raise IOP and improve visual loss from hypotony maculopathy after trabeculectomy with overfiltering blebs.
Department of Ophthalmology, Saint-Sacrement Hospital, Laval University, Quebec. laurence.letartre.1@ulaval.ca
Laurence
L
Letartre
Ahmed
A
Basheikh
Jean-Louis
JL
Anctil
Béatrice
B
Des Marchais
Annie
A
Goyette
Oscar P
OP
Kasner
Caroline
C
Lajoie
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001082:Aqueous Humor / Q000378:metabolism; D003228:Conjunctiva / Q000601:surgery; D005260:Female; D005901:Glaucoma / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000209:etiology / Q000378:metabolism / Q000601:surgery*; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013524:Surgical Flaps; D013536:Suture Techniques; D014130:Trabeculectomy / Q000009:adverse effects*; D014792:Visual Acuity