This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (18)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Ophthalmological Disorders, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

A Prospective, Randomized Pilot Study

Usha Kaul Raina, MD, FRCS, FRCOphth; Deven Tuli, MS

Arch Ophthalmol. 1998;116:1288-1293.

Objective  To compare the short-term and long-term efficacy of using releasable sutures vs conventional interrupted sutures for scleral flap suturing in trabeculectomy.

Design  A prospective randomized study.

Setting  A university-affiliated referral eye hospital.

Patients  Thirty consecutive patients requiring trabeculectomy for uncontrolled primary glaucoma.

Intervention  Fifteen patients underwent trabeculectomy with permanent interrupted sutures; the same number underwent trabeculectomy with releasable sutures.

Main Outcome Measures  Incidence of short-term shallowing of anterior chamber or hypotony and related complications, and long-term intraocular pressure control and bleb score.

Results  The mean percentage reduction in intraocular pressure on day 1 in the group with releasable sutures was 55.2%, while only a 0.8% reduction in anterior chamber depth was noted. This compared with figures of 59.3% and 10.1%, respectively, in the group without releasable sutures. Hypotony (intraocular pressure 6 mm Hg) was noted in 8 (53%) of cases without releasable sutures and 3 (20%) of cases with releasable sutures. Shallow anterior chamber (central anterior chamber depth, 1 mm) was noted in 5 (33%) of cases without releasable sutures and 1 (7%) of cases with releasable sutures. The mean ± SD final bleb score was 5.4±0.3 in the group with releasable sutures compared with 4.2±0.6 in the group without releasable sutures (P<.001). The mean ± SD final intraocular pressure at the end of 12 months was 16.9±1.2 mm Hg in the group without releasable sutures and 15.0±0.9 mm Hg in the group with releasable sutures (P<.001). Final intraocular pressure was controlled (intraocular pressure 21 mm Hg) in all patients in the group with releasable sutures, giving a success rate of 100%, and in 12 patients in the group without releasable sutures, giving a success rate of 80%.

Conclusions  Use of releasable sutures is an effective way at no extra cost or instrumentation to maximize the long-term bleb score and lower intraocular pressure, and to minimize the short-term complications of trabeculectomy.

From the Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Frequency of bleb manipulations after trabeculectomy surgery
King et al.
Br J Ophthalmol 2007;91:873-877.
ABSTRACT | FULL TEXT  

The use of fibrin adhesive in trabeculectomy: a pilot study.
Bahar et al.
Br J Ophthalmol 2006;90:1430-1430.
FULL TEXT