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Editors Selection IGR 10-3
Surgical treatment: Sutureless tunnel
Comment by Tarek Shaarawy on:
24888 The results of trabeculectomy using a sutureless scleral tunnel technique, Eslami Y; Fakhraie G; Amini H et al., International Ophthalmology, 2009; 29: 329-332
The study at hand by Eslami et al. (1679) continues to search for the Holy Grail; a trabeculectomy with less complications. The idea of a sutureless tunnel, with our without an iridectomy, has been contemplated before. In this published report the authors present a six-months follow-up for a three mm in length sutureless tunnel with iridectomy in 17 patients. The authors do not provide detailed description of the surgical technique specifically regarding how was the iridectomy performed through the tunnel, which certainly would be challenging. What is interesting is that the authors report no intraoperative complications, with some immediate post operative complications, including hyphema, flat anterior chambers (3/17), and a failure in two out of the 17 cases to decrease IOP below 21 mmHg with maximal medical therapy.
As always, it is very difficult to draw sensible conclusions from such trials due to the lack of a comparative group. The procedure could potentially be faster and safer than a regular trabeculectomy, and for that reason they are encouraged to conduct a randomized control trial to attempt to answer such open questions.
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