Releasable Suture after Tight Scleral-Flap Trabeculectomy with Mitomycin C

ABSTRACT

Mitomycin C may change the time course for effective releasable scleral-flap suture removal. The authors evaluated the safety and efficacy of releasable scleral-flap sutures in 83 eyes of 61 patients undergoing mitomycin C(MMC) filtering operation. Of these eyes, 38 underwent scleral-flap suture removal and these eyes were divided into three groups according to the timing of suture removal(Group 1 within 3 days after trabeculectomy, Group 2 from 4 to 14 days, Group 3 from 15 to 30 days). The pre-release IOP was 26.0 +/- 7.6, 23.8 +/- 8.5 and 18.4 +/- 4.6 mmHg, respectively. Immediately after releasable suture removal, the percent IOP reduction was 46 +/- 18, 46 +/- 17 and 30 +/- 20%, respectively. The percent IOP reduction after releasable suture removal was greater in the group 1 and group 2 compared with group 3(p<0.05). Mean follow-up period was 9.0 +/- 5.3, 14.4 +/- 7.2 and 12.6 +/- 7.6 months, respectively. Twelve eyes(80%), 12 eyes(100%), 10 eyes(91%) achieved successful control of final IOP of 21 mmHg or less with or without topical antiglaucoma medications, respectively. After releasable suture removal, the shallow anterior chamber was noted in 1 eye, 2 eyes and 1 eye, respectively. One eye developed a hypotony in the group 3. Adjunctive MMC therapy extended the period that releasable scleral-flap suture removal is effective beyond first 2 postoperative weeks. Also these results indicate that this method is efficient for IOP reduction and relatively safe.