Fornix-Based Versus Limbal-Based Conjunctival Trabeculectomy Flaps for Glaucoma: Findings From a Cochrane Systematic...

Area of Science:

• Ophthalmology
• Surgical Innovation
• Glaucoma Management

Background:

• Trabeculectomy is a common surgical procedure for glaucoma.
• Conjunctival flap technique (fornix-based vs. limbal-based) may influence outcomes.
• Evidence comparing these techniques is limited.

Purpose of the Study:

• To systematically review and compare the effectiveness and complications of fornix-based versus limbal-based conjunctival flaps in trabeculectomy surgery for glaucoma.
• To assess the impact of flap technique on intraocular pressure (IOP) control and surgical success.

Main Methods:

• Systematic review of randomized controlled trials (RCTs).
• Searched multiple databases (CENTRAL, MEDLINE, LILACS, etc.) for eligible studies.
• Included adult glaucoma patients comparing fornix- vs. limbal-based trabeculectomy.

Main Results:

• Six RCTs with 361 participants were included.
• No significant difference in trabeculectomy effectiveness (bleb failure, IOP control) between flap types.
• Mean IOP and medication use were similar at 12 and 24 months.
• Increased risk of shallow anterior chamber observed with limbal-based flaps.

Conclusions:

• Both fornix- and limbal-based conjunctival flaps offer similar efficacy for glaucoma control via trabeculectomy.
• Limbal-based flaps are associated with a higher incidence of postoperative shallow anterior chamber.
• Further research may be needed to clarify risk-benefit profiles.