new technique of trabeculectomy with a removable suture

ABSTRACT

In trabeculectomy, the enhanced safety of the filtering procedure is imparted by its scleral flap. The excessive scarring of or inadequate seepage of the aqueous from under the same scleral flap may lead to failure of the operation. To overcome this situation, I have successfully employed in 10 patients the new technique of removable scleral flap suture. In this method, a scleral flap suture is tied with a half bowknot the fixed arm of which is cut short and the sliding arm long enough to be brought outside the conjunctiva and left there until the suture is removed by pulling on it within first five postoperative days. In one patient the suture could not be removed, probably due to its becoming caught in the local scarring. However, its exteriorized arm was pulled and cut so short as to allow its complete retraction under the conjunctive. Out of the 18 patients who had this operation, seven formed good filtration blebs without removal of the suture. This removable suture technique is a very helpful alternative where laser photolysis is unavailable or impracticable. [Pakistan Journal of Ophthalmology 957-59, July, 1993.]