Suturing the bulbar conjunctiva and fascial (sub-Tenon) flap in for filter degree of the bleb in trabeculectomy to treat glaucoma.

Objective To explore the effect of two ways of suturing the bulbar conjunctiva and facial(sub-Tenon) flap on filter degree of the bleb in trabeculectomy for glaucoma.Methods 59 eyes in females and 41 eyes in males,with a mean age of 57 years were enrolled in the treatment group.Of them,58 eyes were acute angle-closure glaucoma in an alleviated period,8 eyes were chronic angle-closure glaucoma and 34 eyes were primary angle-closure glaucoma.58 eyes in females and 42 eyes in males,with a mean age of 59 years were enrolled in the control group.Of them,56 eyes were acute angle-closure glaucoma in an alleviated period,9 eyes were chronic angle-closure glaucoma and 35 eyes were primary angle-closure glaucoma.Filter degree of the follicle of the two ways was recorded at the 1st,6th,12th,18th and 24th month after trabeculectomy using TOPCON slit lamp and the relation between way of suturing and filter degree of the follicle were analyzed.During the operations,2% lidocaine was used for infiltration anesthetization,the bulbar conjunctiva was cut 7.5 mm above the limbus corneae and bluntly separated 2 mm toward the limbus corneae,and the fascial flap was cut.Then the facial flap was continuously sutured with an 8/0 absorbable suture,and the conjunctival flap with an 8/0 absorbable suture.Results The Bleb of the two groups were all well filtered in a 1-6 month period after trabeculectomy and differences between the two groups were not significant(P0.05),but differences in filter degree of the bleb in the two groups were significantly different(P0.05) on the 12th,18th,and 24th month after trabeculectomy,and differences extended with time.Conclusion Cross-bedded suturing of the bulbar conjunctiva and fascial flap caneffectively prevent localization of the follicle and is good for long-term control of intraocular pressure.