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Laser suture lysis after trabeculectomy with mitomycin C: analysis of suture selection
Maria Krömer1, Bernhard Nölle, Florian Rüfer
1*Department of Ophthalmology, Christian Albrechts University †Eye Clinic Bellevue, Lindenallee, Kiel, Germany.
Objective:
This paper analyses to what extent positioning and timing influences the degree of intraocular pressure (IOP) reduction by laser suture lysis (LSL) after trabeculectomy with mitomycin C.
Methods:
The IOP reduction following LSL was assessed in a consecutive case series of 168 eyes (120 patients) after trabeculectomy with mitomycin C. Scleral flap sutures of 3.3±0.6 were placed on average. The IOP reduction was assessed in terms of suture positioning and the time of LSL.
Results:
LSL was performed early (<7 d) on 48 of 168 eyes (29%). The mean IOP before trabeculectomy was 22.1±5.9 and 20.3±6.2 mm Hg on the first postoperative day. LSL additionally reduced the IOP by 6.3±6.9 mm Hg. LSL was performed late (>7 d) on 27 of 168 eyes (16%). The mean preoperative IOP was 20.7±6.0 mm Hg, 12.1±7.8 mm Hg on the first postoperative day, and increased again to 21.7±4.5 mm Hg by the time of LSL. The IOP reduction achieved by LSL was 7.0±5.1 mm Hg. In a subgroup of 54 eyes with 3 scleral flap sutures, there was no significant difference in IOP reduction in a comparison of corner and central sutures (P=0.4). The reduction of IOP after LSL was not significantly correlated with the number of respectively remaining scleral flap sutures (P=0.17). There was no correlation between the time of LSL and IOP reduction (P=0.96).
Conclusion:
The reduction of IOP after LSL is not related to suture selection or the number of remaining scleral flap sutures.
