Efficacy and Complications of Releasable Suture Trabeculectomy and Standard Trabeculectomy

Purpose: To compare the efficacy and complications of releasable suture trabeculectomy and standard trabeculectomy. Patients and Methods: Sixty-four patients with uncontrolled glaucoma despite maximally tolerated medical therapy were included in a prospective, comparative, randomized clinical study. Standard trabeculectomy was performed on the 32 patients (Group 1) by one ophthalmologist and releasable suture trabeculectomy was also performed on the 32 patients (Group 2) by another ophthalmologist. Intraocular pressure, hypotony, shallow anterior chamber, iridocorneal touch and other complications were evaluated postoperatively. Examinations were performed daily for 1 week, for the 1st month and thereafter for every 3 months. Results: The mean follow-up period was 11.0 ± 2.4 months in Group 1 and 11.5 ± 3.8 months in Group 2. On the first postoperative day mean intraocular pressure was determined 9 ± 2.7 mmHg in Group 1, and 21.6 ± 1.1 mmHg in Group 2 (p = 0.007). The mean intraocular pressure was 10.1 ± 1.4 mmHg in Group 2 after suture removal. Shallow anterior chamber was observed in 11 (34.3%) patients of Group 1 and 2 (6.2%) patients of the Group 2 in the early postoperative period (p = 0.005). Iridocorneal touch was observed in 5 (15.6%) patients of Group 1 and 1 (3.1%) patient of Group 2 (p = 0.196). There was no statistically significant difference in the mean intraocular pressure between the two groups at 3, 6 and 12 months (p = 0.663, p = 0.362, p = 0.182, respectively). Discussion: Releasable scleral flap sutures reduce the incidence of shallow anterior chamber and iridocorneal touch after trabeculectomy. Releasable scleral flap suture technique and standard trabeculectomy are similar in terms of lowering intraocular pressure at 1-year-follow up.