A releasable scleral-flap tamponade suture for guarded filtration surgery

Postoperative complications of filtering surgery are generally associated with overfiltration. We describe a technique that employs an externalized releasable suture in partial-thickness filtering surgery. This suture acts as a tamponade on the anterior surface of the scleral flap, assisting in maintenance of anterior-chamber depth during the early postoperative period. After using this technique, anterior-chamber depths preoperatively and 1 day after surgery were compared in 35 phakic patients. A mean (+/- SD) decrease in anterior chamber depth of 4.6% +/- 12% was found on the first postoperative day. One patient had iridocorneal apposition. The mean intraocular pressure 1 day after surgery was 7.0 +/- 7.0 mm Hg, with one patent having an intraocular pressure of 28 mm Hg. This "tamponade suture" appears to be useful in maintaining the anterior chamber depth in the early postoperative period while permitting satisfactory filtration.