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INTRODUCTION: Trabeculectomy is a commonly used surgical treatment for glaucoma. PURPOSE: To evaluate the effectiveness of combination of permanent and releasable scleral flap sutures to minimize the immediate postoperative complications of trabeculectomy. Materials and methods: This study was carried out in Department of Ophthalmology, B P Koirala Institute of Health Sciences, Dharan, Nepal. Forty one eyes of 34 patients undergoing trabeculectomy were randomized to undergo either conventional trabeculectomy (Group A = 20 eyes) or trabeculectomy with combination of permanent and releasable scleral flap sutures (Group B = 21 eyes). The parameters studied were intraocular pressure (IOP), anterior chamber depth (ACD) and surgical complications over a period of 6 weeks. RESULTS: Significantly higher number of eyes belonging to group A (14 eyes) had shallower anterior chamber than group B (7 eyes) on first post operative day (p = 0.042). Six eyes (30%) in group A had peripheral or central irido-corneal touch in early postoperative period as compared to only one in Group B. Hypotony was noted in 3 eyes in each group. Two patients in group A required reformation of anterior chamber. Other surgical complications in the two groups were similar. Both the groups had a significant drop in IOP following surgery. However, there was no significant difference in the IOP between the two groups after 6 weeks (Group A: 10.95 ± 3.03 mmHg vs. Group B: 12.29 &plmmn; 4.67 mmHg; p = 0.87). There was a significant drop in IOP following removal of sutures (15.19 ± 6.15 mmHg to 13.19 &plmmn; 6.13 mmHg; p = 006) in group B. CONCLUSION: Use of combination of permanent and releasable scleral flap sutures is a safe technique that significantly reduces the incidence of immediate postoperative shallow anterior chamber after trabeculectomy.
Dr. B.P. Badhu, B. P. Koirala Institute of Health Sciences, Department of Ophthalmology, Dharan, Sunsari, Nepal. aabadhu@yahoo.com
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)