A modified trabeculectomy technique with direct filtration into the Tenon's capsule
Kaku Itoh1, Shohei Suetake1, Misaki Negishi1
1Departments of Ophthalmology, Muroran City General Hospital, Muroran City, Hokkaido, Japan.
Objective:
To report the surgical outcomes of a modified trabeculectomy technique involving implanting the Tenon's layer under the scleral flap.
Design:
Prospective, interventional case series.
Participants:
51 eyes with medically uncontrolled glaucoma were enrolled for this study. A new trabeculectomy technique, the Tenon's filtration technique for trabeculectomy (TFT-LEC) was used in 26 eyes, while a conventional procedure, normal trabeculectomy (N-LEC), was used for 25 eyes.
Methods:
Intraocular pressure (IOP) control, the number of glaucoma medications, the need for additional interventions, and postoperative complications were assessed.
Results:
Twelve months postoperatively, the mean IOP was 13.5 ± 0.5 mmHg in the TFT-LEC group and 15.4 ± 0.5 mmHg in the N-LEC group (p = 0.13). The TFT-LEC group required an average of 1.3 ± 1.0 additional glaucoma medications (21 cases required only ripasudil) postoperatively, with no cases of bleb needling revision or reoperation. The N-LEC group required an average of 1.7 ± 1.5 glaucoma medications (p = 0.43) compared to TFT-LEC group, eight cases (32%) required bleb needling revision (p = 0.002), and one case (4%) of reoperation (p = 0.49). The complications in the TFT-LEC group included shallow anterior chamber in six (23 %) cases (p = 1.00) compared to N-LEC group, choroidal detachment in two (8%) cases (p = 0.42), and anterior chamber hemorrhage in seven (27%) cases (p = 0.29). None of these complications affected visual function.
Conclusions:
This new technique involving implanting the Tenon's layer under the scleral flap may improve the postoperative outcomes of trabeculectomy.
