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Abstract #24910 Published in IGR 11-4
Transconjunctival suturing of the scleral flap for overfiltration with hypotony maculopathy after trabeculectomy
Letartre L; Basheikh A; Anctil JL; Des Marchais B; Goyette A; Kasner OP; Lajoie CCanadian Journal of Ophthalmology 2009; 44: 567-570
See also comment(s) by Esther Hoffmann •
OBJECTIVE: To assess the efficacy of transconjunctival suturing of the scleral flap in improving hypotony maculopathy resulting from overfiltration after trabeculectomy. DESIGN: Retrospective review. PARTICIPANTS: 35 eyes of 33 patients. METHODS: Patients underwent transconjunctival scleral flap suturing for hypotony maculopathy following trabeculectomy using mitomycin C. The scleral flap was sutured through the conjunctiva as an outpatient clinic procedure using a spatulated needle with a 10-0 nylon suture. RESULTS: The average age of the patients was 67.5 (SD 4.80, range 39-83) years, and 52% patients were male. The average duration of hypotony prior to transconjunctival suturing of the flap was 108.0 (SD 68.3) days. The median intraocular pressure (IOP) before suturing was 3 mm Hg, and the median IOP 6 months after the procedure was 9 mm Hg (p < 0.0001). The median best-corrected visual acuity (BCVA) before transconjunctival suturing of the scleral flap was 20/100, and the median BCVA 6 months after the procedure was 20/30 (p < 0.0001). Compared with visual acuity before suturing the average gain in BCVA was 4.9 (SD 0.8) lines. CONCLUSIONS: Transconjunctival suturing of the trabeculectomy scleral flap is an effective treatment to raise IOP and improve visual loss from hypotony maculopathy after trabeculectomy with overfiltering blebs.
Department of Ophthalmology, Saint-Sacrement Hospital, Laval University, Quebec. laurence.letartre.1@ulaval.ca
Classification:
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)