Fornix-based Trabeculectomy With Mitomycin C Using the Horizontal Conjunctival Suture Technique.
OBJECTIVE
The aim of this study was to determine the safety, efficacy, and bleb morphology of fornix-based trabeculectomy with mitomycin C using the horizontal suture technique.


METHODS
A retrospective noncomparative case series of 79 eyes of 69 patients, who underwent fornix-based trabeculectomy with mitomycin C, was studied. Conjunctival closure of all eyes was with the horizontal suture technique using 10-0 nylon suture to prevent bleb leakage and improve bleb morphology posttrabeculectomy. The main outcome measures were the bleb morphology, outcome of surgery, and complications posttrabeculectomy.


RESULTS
At a mean follow-up period of 25.5±9.3 months, 65 eyes (82.3%) had diffuse blebs with horizontal extent between 2 and 4 clock hours. Low-lying bleb was found in 35 eyes (44.3%), whereas 39 eyes (49.4%) had moderately elevated bleb. Fifty-one eyes (64.6%) had complete success, 18 eyes (22.8%) had qualified success, whereas 10 eyes (12.6%) were classified as treatment failures. Overall, 87.4% of the patients had a successful outcome. Corneal encroachment/overhanging blebs were found in 3 eyes (3.8%). Bleb leakage was found in 7 eyes (8.8%). There was overfiltration in 2 eyes (2.5%) with shallow anterior chamber.


CONCLUSIONS
The horizontal suture technique is an easily applied, less time-consuming technique that gives excellent bleb morphology with few complications in the long term.
*Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea †Fukushima Eye Clinic, Osaka, Japan.
Olusola
O
Olawoye
Myungwon
M
Lee
Yasuaki
Y
Kuwayama
Changwon
C
Kee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000477:Alkylating Agents / Q000008:administration & dosage*; D003228:Conjunctiva / Q000187:drug effects / Q000601:surgery*; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013536:Suture Techniques; D014130:Trabeculectomy / Q000379:methods*
D000477:Alkylating Agents; D016685:Mitomycin