title: Laser suture lysis after trabeculectomy with mitomycin C: analysis of suture selection.
abstract: OBJECTIVE
  This paper analyses to what extent positioning and timing influences the degree of intraocular pressure (IOP) reduction by laser suture lysis (LSL) after trabeculectomy with mitomycin C.
  
  
  METHODS
  The IOP reduction following LSL was assessed in a consecutive case series of 168 eyes (120 patients) after trabeculectomy with mitomycin C. Scleral flap sutures of 3.3±0.6 were placed on average. The IOP reduction was assessed in terms of suture positioning and the time of LSL.
  
  
  RESULTS
  LSL was performed early (<7 d) on 48 of 168 eyes (29%). The mean IOP before trabeculectomy was 22.1±5.9 and 20.3±6.2 mm Hg on the first postoperative day. LSL additionally reduced the IOP by 6.3±6.9 mm Hg. LSL was performed late (>7 d) on 27 of 168 eyes (16%). The mean preoperative IOP was 20.7±6.0 mm Hg, 12.1±7.8 mm Hg on the first postoperative day, and increased again to 21.7±4.5 mm Hg by the time of LSL. The IOP reduction achieved by LSL was 7.0±5.1 mm Hg. In a subgroup of 54 eyes with 3 scleral flap sutures, there was no significant difference in IOP reduction in a comparison of corner and central sutures (P=0.4). The reduction of IOP after LSL was not significantly correlated with the number of respectively remaining scleral flap sutures (P=0.17). There was no correlation between the time of LSL and IOP reduction (P=0.96).
  
  
  CONCLUSIONS
  The reduction of IOP after LSL is not related to suture selection or the number of remaining scleral flap sutures.
authors.affiliation: *Department of Ophthalmology, Christian Albrechts University †Eye Clinic Bellevue, Lindenallee, Kiel, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Krömer
authors.forename: Bernhard
authors.initials: B
authors.lastname: Nölle
authors.forename: Florian
authors.initials: F
authors.lastname: Rüfer
mesh_terms: D000368:Aged; D000477:Alkylating Agents / Q000008:administration & dosage*; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D012590:Sclera / Q000187:drug effects; D013524:Surgical Flaps; D013536:Suture Techniques; D013537:Sutures; D014130:Trabeculectomy / Q000379:methods*
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin