Comparison of a Modified Trabeculectomy Technique With Standard Trabeculectomy in Respect to Effectivity and...

To compare the results of modified trabeculectomy with a central scleral gutter under the flap and releasable suture with standard trabeculectomy for open angle glaucoma cases.

Retrospective.

This retrospective comparative case series evaluated the outcomes of modified trabeculectomy in 32 eyes and standard trabeculectomy in 44 eyes with primary open-angle glaucoma or pseudoexfoliative glaucoma. Success was defined as achieving an intraocular pressure (IOP) ≤ 21 mmHg with or without the use of IOP-lowering eyedrops and no need for additional glaucoma surgery.

There were 20 men (62.5%) and 12 women (37.5%), with a mean age of 61.9 ± 10.5 years in the modified trabeculectomy group and 27 men (61.4%) and 17 women (38.6%), with a mean age of 62.3 ± 9.8 years in the standard trabeculectomy group. Modified trabeculectomy group had a preoperative IOP of 26.9 ± 8.1 mmHg and a postoperative IOP of 15.3 ± 4.1 mmHg (p < 0.001), with an average follow-up period of 38.5 ± 17.2 months. Patients undergoing standard trabeculectomy had a preoperative IOP of 26.7 ± 8.7 mmHg and a postoperative IOP of 14.5 ± 4.6 mmHg (p < 0.001), with an average follow-up period of 42.4 ± 9.4 months. The success rate was 97.7% in the standard trabeculectomy group and 96.8% in the modified trabeculectomy group. In the modified trabeculectomy group, 30 (93.7%) had no complications, compared to 33 (75%) in the standard trabeculectomy group (p = 0.03). Anterior chamber shallowing was observed in 2 eyes (6.3%) in the modified trabeculectomy group, whereas the standard trabeculectomy group exhibited a broader complication profile, including anterior chamber shallowing in 4 eyes (9.0%), needling revision in 3 eyes (6.8%), hyphema in 2 eyes (4.5%), and choroidal detachment in 2 eyes (4.5%).

The modified trabeculectomy surgery lowers IOP effectively with a lower incidence of postoperative surgical complications.