A new 6 o'clock traction suture technique for glaucoma filtration surgery.
OBJECTIVE
Recent studies show that using a traction suture through the superior rectus muscle in filtering glaucoma surgery is associated with a lower success rate compared with a corneal traction suture. A 12 o'clock corneal traction suture combined with a fornix-based approach may distort the architecture of the scleral flap.


METHODS
In a new technique, a corneal 6 o'clock traction suture is placed near the limbus, thus avoiding any disturbance at the site of filtering surgery. The suture is passed underneath a notched solid-bladed lid speculum that pushes the suture deep into the inferior fornix and rotates the eye downward.


RESULTS
In 20% a hemostat was needed to fix the suture to the surgical drape. During a period of 26 months and 412 trabeculectomies only 1 corneal perforation in an adult patient with congenital glaucoma and thin cornea was seen.


CONCLUSIONS
The 6 o'clock traction suture with the glaucoma lid speculum is easy to learn and safe.
Grehn
Franz
F
Department of Ophthalmology, University Hospital Wuerzburg, Wuerzburg, Germany.
Klink
Thomas
T
D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D011183:Postoperative Complications; D013536:Suture Techniques; D014130:Trabeculectomy / Q000379:methods*