Expanded indications for transconjunctival trabeculectomy flap suturing: postoperative choroidal effusion and dysesthesia.
OBJECTIVE
To assess the efficacy of transconjunctival trabeculectomy flap suturing (TTFS) in improving choroidal effusions and bleb dysesthesia resulting from overfiltration after trabeculectomy.


METHODS
Retrospective review.


METHODS
The study involved 15 eyes of 15 patients.


METHODS
Patients underwent TTFS for choroidal effusions and bleb dysesthesia following trabeculectomy using mitomycin C. The scleral flap was sutured through the conjunctiva as an outpatient clinic procedure.


RESULTS
There were 11 patients who had choroidal effusions and 4 patients were identified with dysesthesia. The average duration of choroidal effusion prior to TTFS was 2.1 ± 2.3 months and 3 ± 2 months in the dysesthesia group. At the final follow-up (25 ± 17 months) the mean intraocular pressure improved from 4.1 ± 2.1 mm Hg before suturing to 8.1 ± 3.6 mm Hg (p < 0.007) for the patients with choroidal effusion and from 4.2 ± 0.6 mm Hg to 8. 7 ± 3.5 mm Hg (p = 0.05) for the patients with dysesthesia. In both groups, resolution of the signs and symptoms was achieved in all cases. The mean time to resolution of choroidal effusions was 5.5 ± 8.6 weeks and the mean time to resolution of dysesthesia was 2 ± 0.8 weeks. None of the patients had serious complications such as failure of the trabeculectomy or visual loss.


CONCLUSIONS
Transconjunctival suturing of the trabeculectomy scleral flap is a simple and effective surgical method for the treatment of cases of choroidal effusions or dysesthesia resulting from trabeculectomy.
Henry C. Witelson Ocular Pathology Laboratory, McGill University, Montreal, Que.
Dana
D
Faingold
Oscar P
OP
Kasner
D000368:Aged; D000369:Aged, 80 and over; D015862:Choroid Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003228:Conjunctiva; D005122:Exudates and Transudates; D005260:Female; D005901:Glaucoma / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010292:Paresthesia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013524:Surgical Flaps; D013536:Suture Techniques; D014130:Trabeculectomy; D016896:Treatment Outcome