title: Sutureless Scleral Tunnel Trabeculectomy: Evaluation of Feasibility and Effectiveness versus Conventional Trabeculectomy for Management of Primary Open Angle Glaucoma.
abstract: OBJECTIVE
  To evaluate the intraocular pressure-lowering effect of sutureless scleral tunnel trabeculectomy with Mitomycin-C (MMC) compared to the standard trabeculectomy with MMC in patients with primary open angle glaucoma (POAG).
  
  
  METHODS
  This was a masked, randomized, controlled comparison trial involving 34 eyes of 34 patients with bilateral POAG. Patients were randomized to receive sutureless sclera flap trabeculectomy with MMC or conventional trabeculectomy with MMC. The main outcome for comparison was the IOP-lowering effect of both procedures. Complete surgical success was considered if the patient's IOP was <22 mmHg and the IOP were lowered by more than 20% with the use of maximum two anti-glaucoma medications.
  
  
  RESULTS
  All surgeries passed uneventfully without intraoperative complications and all patients showed significantly (p<0.05) lower IOP on the first postoperative day compared to their respective preoperative IOP with non-significant (p>0.05) difference between both study groups. All patients, irrespective of operative procedure, maintained significantly (p<0.05) lower IOP compared to their respective preoperative IOP until the end of 12 months' follow-up. There were no recorded serious postoperative complications in either groups, like wound leaks or endophthalmitis.
  
  
  CONCLUSIONS
  Sutureless scleral tunnel trabeculectomy exhibits potential as an alternative to conventional trabeculectomy surgery. Over 12 months of follow-up, sutureless sclera flap trabeculectomy was safe and effective with an IOP-lowering effect comparable to that achieved with the conventional technique, but with increased rate of postoperative transient hypotony.
authors.affiliation: a Menoufia University Hospitals , Menoufia , Egypt.
authors.forename: Hany A
authors.initials: HA
authors.lastname: Khairy
authors.affiliation: a Menoufia University Hospitals , Menoufia , Egypt.
authors.forename: Moataz F
authors.initials: MF
authors.lastname: Elsawy
authors.affiliation: a Menoufia University Hospitals , Menoufia , Egypt.
authors.forename: Khaled
authors.initials: K
authors.lastname: Said-Ahmed
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D005240:Feasibility Studies; D005260:Female; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques; D014130:Trabeculectomy / Q000379:methods*
chemical_list: D000959:Antihypertensive Agents; D016685:Mitomycin
keywords: Mitomycin-C; primary open angle glaucoma; sutureless scleral tunnel; trabeculectomy