[Comparison of trabeculectomy with and without releasable suture]

ABSTRACT

To compare the short and long-term efficacy and complications of releasable suture vs. conventional interrupted suture for scleral flap in trabeculectomy. In a prospective randomized clinical trial, 42 eyes of 42 consecutive patients requiring trabeculectomy for uncontrolled primary glaucoma underwent conventional trabeculectomy [group A] and trabeculectomy with releasable sutures [group B]; 21 eyes of 21 patients for each group. Short-term hypotony related complications and long-term intraocular pressure were measured and compared. The mean follow up was 11.7 +/- 6.5 months in group A and 9.4 +/- 6.4 months in group B. The mean 5 SD final intraocular pressure at the end of follow up period was 13.95 +/- 4 mrnHg in group A and 14.57 +/- 3 mmHg in group B [P= 0.58]. Mean reduction in intraocular pressure at the end of follow up was 54.5% in group A and 56% in group B. Final intraocular pressure was controlled [lOP patients in group A giving a success rate of 71.4% and in 14 patients in group B giving a success rate of 66.7%. Flat anterior chamber [grade III] was observed in 2 eyes in group A but in no eyes with releasable suture. At the end of follow up, the two groups were similar regarding intraocular pressure and need for ocular hypotensive medication. Releasable scleral flap sutures reduce the incidence of hypotony and related complication without any effects on long-term control of intraocular pressure and is an effective way with no extra cost or instrument