A modified trabeculectomy technique with direct filtration into the Tenon's capsule

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Surgical Innovation

Background:

• Glaucoma management often requires surgical intervention to control intraocular pressure (IOP).
• Trabeculectomy is a common glaucoma surgery, but outcomes can be variable.
• Modifications to existing surgical techniques are continuously explored to improve efficacy and safety.

Purpose of the Study:

• To evaluate the surgical outcomes of a novel trabeculectomy technique.
• To compare the efficacy and safety of the Tenon's filtration technique for trabeculectomy (TFT-LEC) against conventional trabeculectomy (N-LEC).

Main Methods:

• A prospective, interventional case series involving 51 eyes with medically uncontrolled glaucoma.
• Patients were divided into two groups: 26 eyes underwent TFT-LEC, and 25 eyes underwent N-LEC.
• Outcomes assessed included IOP control, medication usage, need for interventions, and postoperative complications over 12 months.

Main Results:

• The TFT-LEC group achieved a mean IOP of 13.5 mmHg, compared to 15.4 mmHg in the N-LEC group.
• Fewer additional glaucoma medications were required in the TFT-LEC group (1.3 vs. 1.7).
• The TFT-LEC group had significantly fewer bleb needling revisions (0 vs. 32%) and no reoperations, with similar complication rates and no impact on visual function.

Conclusions:

• Implanting the Tenon's layer under the scleral flap in trabeculectomy may enhance postoperative outcomes.
• The TFT-LEC technique shows potential for improved IOP control and reduced need for interventions post-surgery.
• This modified approach warrants further investigation for its role in glaucoma management.