Adjustable sutures in glaucoma filtering surgery

ABSTRACT

Sixty eyes with uncontrolled glaucoma constituted the material of this work. The control group [20 eyes] was operated upon following the classic trabeculectomy operation. Trabeculectomy with two adjustable sutures was performed for the remaining 40 eyes. Their postoperative course was uneventful in 23 out of the 40 eyes. Five eyes suffered from uveitis which was mild in 4 but severe in fifth eye, ending in posterior synechiae and complicated cataract. Trace hyphema occurred in two eyes but disappeared in a few days. Progression of already present cataract was noticed in two eyes. Marked postoperative hypotony and very shallow anterior chamber were recorded in five eyes in addition to three eyes of the control group. Two eyes of the control group improved on medical treatment and third one required air reformation of the anterior chamber. Tightening of one adjustable suture succeeded in restoration of the intraocular pressure in 3 eyes. The other 2 eyes were successfully managed by tightening of the second suture. Two out of the 40 eyes and 2 of the control group developed postoperative rise of intraocular pressure. One of the control cases responded to medical therapy and the second one required anothor operation. Loosening of one adjustable suture cured one eye. The second eye required loosening of the other suture. In conclusion, adjustable sutures may be used in glaucoma fistering surgery for better management of excessive postoperative rise or drop of intraocular pressure