title: Comparison of 3 different releasable suture techniques in trabeculectomy.
abstract: OBJECTIVE
  The use of releasable sutures provides an effective and simple way of titrating intraocular pressure (IOP) postoperatively. The purpose of this study was to compare the surgical outcome of 3 releasable suture techniques for closing scleral flaps in patients undergoing primary trabeculectomy.
  
  
  METHODS
  The Wills Eye Glaucoma Research Center retrospectively reviewed the charts of patients who underwent primary trabeculectomy by 3 surgeons using 3 different releasable suture techniques. Ninety eyes of 90 glaucoma patients were divided into 3 groups by releasable suture technique (n = 30 eyes for each group). Main outcome measures included best-corrected visual acuity (BCVA), intraocular pressure (IOP), rate of surgical success, use of supplemental medical therapy, need for additional glaucoma surgery, and complications during suture removal.
  
  
  RESULTS
  The BCVA and IOP were similar among the groups for all follow-up visits. As a determinant of success rate of trabeculectomy, mean decrease of IOP after surgery was over 30% in all groups (p = 0.43). The number of postoperative antiglaucomatous medications, number of complications, and need for an additional glaucoma surgery were similar in all groups (p = 0.40, p = 0.87, and p = 0.47, respectively). The differences in suture-related complications, defined as suture break or need for laser suture lysis, were not significant among the groups (p = 0.09).
  
  
  CONCLUSIONS
  We found that the 3 most common surgical techniques had similar mechanisms of action. All techniques were safe and effective, yielding similar outcomes. All 3 techniques can be used for closing scleral flaps in patients undergoing primary trabeculectomy.
authors.affiliation: Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA - USA.
authors.forename: Fulya
authors.initials: F
authors.lastname: Duman
authors.affiliation: Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA - USA.
authors.forename: Bruno
authors.initials: B
authors.lastname: Faria
authors.affiliation: Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA - USA.
authors.forename: Nont
authors.initials: N
authors.lastname: Rutnin
authors.affiliation: Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA - USA.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Guzel
authors.affiliation: Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA - USA.
authors.forename: Feyzahan
authors.initials: F
authors.lastname: Ekici
authors.affiliation: Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA - USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Waisbourd
authors.affiliation: Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA - USA.
authors.forename: L Jay
authors.initials: LJ
authors.lastname: Katz
authors.affiliation: Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA - USA.
authors.forename: Marlene R
authors.initials: MR
authors.lastname: Moster
authors.affiliation: Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA - USA.
authors.forename: George L
authors.initials: GL
authors.lastname: Spaeth
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013524:Surgical Flaps; D013536:Suture Techniques; D013537:Sutures; D014065:Tonometry, Ocular; D014130:Trabeculectomy / Q000379:methods*; D014792:Visual Acuity / Q000502:physiology