The Usefulness of External Bandage Suture for Management of Bleb after Trabeculectomy with Mitomycin C

ABSTRACT

PURPOSE: To evaluate the usefulness of external bandage suture for bleb-related management that follows trabeculectomy with mitomycin C. METHODS: External bandage sutures were performed on 10 patients having hypotony maculopathy, persistent low intraocular pressure (IOP) caused by either hyperfiltration or focal leakage, or a persisting large bleb caused by hyperfiltration and who received trabeculectomy using mitomycin C as an adjuvant treatment. The changes in IOP measured before and 4 weeks after the procedure along with complication incidences were evaluated. RESULTS: The mean IOP 4 weeks after the procedure compared with the mean IOP prior to the procedure increased from 5.8 +/- 2.0 mm Hg (3.0-9.0 mm Hg) to 14.1 +/- 8.5 mm Hg (4.0-32.0 mm Hg), with statistical significance (p = 0.008). After the procedure, improvement in visual acuity was observed but without statistical significance. One patient had persistent focal leakage from an avascular bleb and conjunctival advancement with removal of the avascular conjunctiva was performed. CONCLUSIONS: An external bandage suture can be a good alternative for correction of post-trabeculectomy hypotony and severe chemosis with minimal effect on blebs while correcting focal leakage and hyperfiltration.