"Scleral tunnel incision"-trabeculectomy with one releasable suture.

Abstract

PURPOSE To describe a modified surgical technique, a scleral tunnel incision- trabeculectomy (STIT) and evaluate its safety and efficacy in lowering IOP in glaucoma patients. METHODS One hundred and three patients were included in a retrospective, nonrandomized clinical study. Fifty-three patients were operated conventionally and 40 patients underwent STIT. In the modified technique the sides of the scleral flap are opened only half-way to the limbus and the flap is closed with a single releasable "slipknot"-suture. RESULTS The mean IOP on the first postoperative day was 4.5 +/- 6.8 mmHg in the conventional group and 7.4 +/- 7.1 mmHg in the tunnel incision group (p = 0.012). On the second postoperative day the mean IOP was 4.5 +/- 7.3 mmHg and 6.3 +/- 6.5 mmHg in the conventional group and tunnel incision group, respectively (p = 0.065). There was no statistically significant difference in the mean postoperative IOP between the groups at one month and at 6-12 months. Shallow anterior chamber and iridocorneal touch occurred statistically significantly less in the tunnel incision group than in the conventional group. CONCLUSION STIT appears to be equivalent to conventional trabeculectomy (CT) in lowering IOP during the first 6-12 months postoperatively. It is also relatively safe and has fewer early complications related to excessive aqueous outflow than CT.