Releasable suture in phacotrabeculectomy

ABSTRACT

An externalized releasable suture in phacotrabeculectomy, does not use scleral flap for trabeculectomy but excised posterior lip of sclera ltunnel incision is use to create a fisutula. This provides early visual rehabilitation, good control of postoperative intraocular pressure, maintenance of chamber depth during early postoperative period and reduction of the extent of tissue dissection which may decrease the stimuleus to wound healing and early filteration failure with few complication. We reviewed the effectiveness of an externalized releasable suture in phacotrabeculectomy using 6mm scleral tunnel incision after 6 months of follow-up in 10 eyes of 8 patients with coexisting cataract and glaucoma. At 6 months after operation, the mean intraocular pressure reduction was 13.2 mmHg postoperatively and the number of glaucoma medication decreased from 2.4 to 0.3. NO medication was needed in 8 eyes postoperatively. The visual acuity improved in all eyes and 7 eyes recoveed to 20/40 or better. The several complications such as partial posterior capsule rupture, transient wound leakage, posterior capsule opacity were noted. NO case of shallow anterior chamber was found. $ eyes had slightly increased IOP in the early postoperative period, and subsequent suture removal reduced IOP. In all cases, depth of anterior chamber was well formed. The releasable suture in combined procedure provides a low incidence of postoperative complication due to overfilteration, and makes it possible to increase the degree of filteration by removal when needed during the early postoperative period. this reduces the incidence of shallow and flat anterior chamber without compromising long-term control of intraocular prssure.