Early efficacy and complications of releasable sutures for trabeculectomy in primary angle-closure glaucoma: a randomized clinical trial.
OBJECTIVE
To compare the postoperative intraocular pressure (IOP) and incidence of early complications after trabeculectomy with releasable suture to standard trabeculectomy in Chinese patients with primary angle-closure glaucoma.


METHODS
One hundred seventy-five patients diagnosed as primary angle-closure glaucoma with 6 clock-hours or more of peripheral anterior synechia were randomly allocated to 2 treatment groups: 87 underwent standard trabeculectomy (S group: 2 interrupted permanent sutures to the scleral flap) and 88 received trabeculectomy with 2 permanent and 2 releasable sutures (R group). The postoperative IOP and complications during the first 3 months after surgery were compared.


RESULTS
One hundred seventy-one patients (97.7%) attended the 3-month visit. The IOP in the first week after trabeculectomy was significantly higher in the R group: day 1, 17.3±8.6 versus 12.7±6.0 mm Hg (P<0.001); day 3, 18.0±7.3 versus 12.9±6.3 mm Hg (P<0.001); day 7, 14.8±6.3 versus 12.0±4.9 mm Hg (P=0.001), but no difference was observed after the second week (P=0.659 to 0.753). The incidence of transient hypotony was higher in S group (20.4%) than the R group (9.1%) (P=0.046); hypotony recovered in 80.8% (21/26) within 1 week. There was no difference in the occurrence of shallow chamber, choroidal detachment, macular edema, additional surgery, or hyphema (P=0.56 to 1.0).


CONCLUSIONS
The technique of releasable sutures for trabeculectomy used in this study did not demonstrate significant advantages over standard trabeculectomy. Releasable sutures were associated with some decrease in visual acuity and increase in postoperative complaints.
*Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University †Beijing Ophthalmology & Visual Science Key Lab, Beijing ‡Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong §Anyang Eye Hospital, Anyang, Henan Province ∥Handan Eye Hospital, Handan, Hebei Province ¶Fushun Eye Hospital, Fushun, Liaoning Province #Ophthalmology and Optometry Hospital, Chenzhou, Hunan Province, P.R. China **Queensland Eye Institute, University of Queensland, Brisbane, Australia.
Yuan B
YB
Liang
Mei Y
MY
Feng
Hai L
HL
Meng
Su J
SJ
Fan
Xing
X
Wang
Li L
LL
Xie
Peng
P
Yi
Xin
X
Tang
Ning L
NL
Wang
Ravi
R
Thomas
D005260:Female; D015812:Glaucoma, Angle-Closure / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D013536:Suture Techniques / Q000009:adverse effects*; D013537:Sutures; D014129:Trabecular Meshwork / Q000601:surgery*; D014130:Trabeculectomy; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology