Limbus- v fornix-based conjunctival flap in trabeculectomy. A long-term randomized study
J. N. Shuster, T. Krupin, A. E. Kolker and B. Becker
The safety and success rates of trabeculectomy using fornix-based or
limbus-based conjunctival flaps were investigated in a randomized,
prospective study. Patients with phakic eyes and uncontrolled primary
open-angle glaucoma had a trabeculectomy with either a standard
limbus-based conjunctival flap (18 eyes) or a fornix-based conjunctival
flap (19 eyes). Filtration surgery was equally successful (intraocular
pressure, less than or equal to 21 mm Hg) in both groups independent of the
type of conjunctival flap: 17 (94%) of 18 eyes with a limbus-based flap
(three eyes with additional medical therapy) and 17 (89%) of 19 eyes with a
fornix-based flap (three eyes with additional medical therapy). Four eyes
in the fornix-based group showed positive Seidel tests in the early
postoperative period. Aqueous leakage was from the suture sites at the
lateral margins of the flap and resolved spontaneously without surgical
intervention. The fornix-based conjunctival flap was easier to perform,
provided better surgical exposure, and was easier to close than the
limbus-based flap.
