title: A randomised clinical trial comparing the outcome of trabeculectomy using triangular versus rectangular scleral flaps.
abstract: BACKGROUND
  trabeculectomy is the standard surgical procedure for management of glaucoma.
  
  
  OBJECTIVE
  to compare the outcome of triangular and rectangular scleral flaps in trabeculectomy.
  
  
  METHODS
  this study was carried out in the Department ofOphthalmology, BPKIHS, Dharan, over a period of one year. A total of 22 patients undergoing trabeculectomy were randomized to undergo either trabeculectomy with triangular scleral flap (Group A= 11 eyes) or trabeculectomy with rectangular flap (Group B = 11 eyes).
  
  
  METHODS
  the parameters studied were intraocular pressure (IOP), anterior chamber depth (ACD), bleb characteristics and surgical complications.
  
  
  METHODS
  P value of<0.05 was considered significant. All calculations were executed using SPSS 11.0 software program.
  
  
  RESULTS
  the age ranged between 40 to 76 years with the mean of 56.5 +/- 9.25 years. The most common preoperative diagnosis was angle closure glaucoma. The postoperative percentage of IOP reduction (Group A=68.9%; Group B=66.51%) was statically significant in both the groups (p=0.001). Trabeculectomy was almost equally effective with complete surgical success of 91% in group A, and 82% in group B (p=0.534). Final bleb scores were almost similar in both the groups with 3.27 +/- 1.5 in group A and 3.36 +/- 1.21 in group B (p=0.877). Hypotony with the IOP less than 6 mmHg was found in the first post-operative day in 2 patients in Group A and in 1 in Group B. All of them improved spontaneously within a week.
  
  
  CONCLUSIONS
  both triangular and rectangular scleral flaps in trabeculectomy are equally effective in terms of post surgical IOP control, bleb characteristics and complications.
authors.affiliation: Department of Ophthalmology, B P Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal. ophth_eye@yahoo.com
authors.forename: A
authors.initials: A
authors.lastname: Sharma
authors.forename: H
authors.initials: H
authors.lastname: Das
authors.forename: S
authors.initials: S
authors.lastname: Adhikari
authors.forename: P
authors.initials: P
authors.lastname: Lavaju
authors.forename: B G
authors.initials: BG
authors.lastname: Shrestha
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012590:Sclera / Q000637:transplantation*; D013524:Surgical Flaps; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome