title: Trabeculectomy with or without anterior chamber maintainer and adjustable sutures.
abstract: OBJECTIVE
  To assess the long-term outcomes of trabeculectomy using an anterior chamber maintainer and a combination of adjustable and releasable sutures compared with trabeculectomy using a viscoelastic and solely releasable sutures.
  
  
  METHODS
  In a prospective, randomized, single-center study, 2 different trabeculectomy techniques were compared. One eye of each patient was randomly assigned to trabeculectomy with an anterior chamber maintainer and a combination of 2 adjustable and 2 releasable flap sutures (technique 1), whereas the other eye had trabeculectomy with viscoelastic and 2 releasable flap sutures (technique 2). The postoperative management was comparable in both groups except for the manipulation of the adjustable sutures. The main outcome measures were the postoperative intraocular pressure (IOP), the frequency of early postoperative complications and interventions, and the number of glaucoma medications.
  
  
  RESULTS
  Thirty-two patients were included and had a follow-up of at least 18 months. The preoperative and postoperative IOP at 18 months was 22.1±8 and 13.3±2 mm Hg in the group using technique 1 and 22.7±7 and 13.3±3 mm Hg in the group using technique 2, respectively (mean±SD; P=0.18 for IOP reduction between both techniques). Early postoperative complications and interventions were infrequent and comparable in both techniques. The reduction in number of medications was not significantly different between the 2 groups (mean±SD from 2.4±1.0 to 0.4±0.8 in the group using technique 1 and from 2.3±1.0 to 0.2±0.5 in the group using technique 2; P=0.50).
  
  
  CONCLUSIONS
  There is no significant difference in IOP reduction, in frequency of postoperative complications and interventions, or in reduction of medications between the 2 techniques.
authors.affiliation: *Department of Ophthalmology, University Hospitals Leuven †Laboratory of Ophthalmology, Department of Ophthalmology Neurosciences, KU Leuven, Leuven, Belgium ‡Department of Ophthalmology, University Hospital Maastricht, Maastricht §Department of Ophthalmology, Leids University Medical Centre, Leiden, The Netherlands.
authors.forename: Evelien
authors.initials: E
authors.lastname: Vandewalle
authors.forename: Sara
authors.initials: S
authors.lastname: Van de Veire
authors.forename: Charlotte
authors.initials: C
authors.lastname: Renier
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Stalmans
authors.forename: Thierry
authors.initials: T
authors.lastname: Zeyen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000601:surgery*; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D019736:Prostheses and Implants; D013536:Suture Techniques; D014065:Tonometry, Ocular; D014129:Trabecular Meshwork / Q000601:surgery*; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D055675:Viscosupplements / Q000008:administration & dosage
chemical_list: D055675:Viscosupplements