Adjustable temporal suture in trabeculectomy with scleral flap

The long-term success of trabeculectomy depends primarily on the degree of scarring that occurs to the artificial filtration route that is created by the procedure. The most serious postoperative complication of trabeculectomy is a persistent shallow anterior chamber or a flat chamber. The objective of this study was to evaluate the effect of a suturing technique on the long-term success of trabeculectomy.

In this study, the authors analyzed a trabeculectomy technique that is based on the application of a suture of variable tightness on the scleral flap. The technique was performed on 11 patients subjected to trabeculectomy.

The postoperative complication of shallow anterior chamber was successfully treated with further tightening of the suture for one patient. For each patient, the authors loosened the suture on the fourth postoperative day and removed it completely on the seventh or eighth postoperative day. The patients were observed postoperatively for a minimum of 1 year. During this period the intraocular pressure for each patient was within the normal limits.

The authors contend that this trabeculectomy technique, in which a suture on the scleral flap can be adjusted for tightness and is later removed, contributes significantly to the treatment of a postoperative shallow anterior chamber or a flat chamber and to the long-term function of an effective filtration fistula.