Vol. 77, September 2009

Relaesable Scleral Flap Suture in Trabeculectomy: Preliminary Results of a New Technique

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Relaesable Scleral Flap Suture in Trabeculectomy: Preliminary Results of a New Technique,MOHAMAD H. HOSNY, AHMAD M.M. SHALABY and HESHAM M. HOSNY

 

Abstract
Purpose: To demonstrate a technique for a releasable scleral flap suture placed to reduce post-trabeculectomy complications.
Methods: Under a fornix based conjunctival flap, a rect-angular partial thickness scleral flap is fashioned. A sclerostomy is made followed by a peripheral iridectomy and the scleral flap is secured. A trapezoid suture is then placed from the sclera across the scleral flap to exit on the corneal surface and then tightend under the conjunctival flap which is then secured. During the follow-up, this suture can be safely removed on the slit lamp if the IOP is high. If the IOP is ideal, the suture can be left in place.
Results: Immediate postoperative complications as flat anterior chamber and choroidal detachment didn't occur. The suture was removed only if the filtration was not sufficient and the IOP was high.
Conclusion: The releasable scleral flap suture was effective in preventing post trabeculectomy complications. In addition, it can be easily removed on the slit lamp without the need to fish under the conjunctiva, or to search for equipments as lasers.

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