Analysis of the effect of shoelace continuous suture for conjunctival incision on preventing postsurgical shallow anterior chamber

Abstract

Objective To analyze the effect of shoelace continuous suture for conjunctival incision on preventing postsurgical shallow anterior chamber. Methods Forty-one patients (82 eyes) diagnosed as primary glaucoma, and treated with trabeculectomy were included in this study during the period from March 2011 to March 2016. One eye, which was randomly chosen and applied shoelace continuous suture to attach the conjuctival fornix flap to the cornea, was included in observation group; the other eye, which under went same surgical procedure but applied conjuctival interrupted suture, was included in the control group. Intraocular pressure (IOP) and anterior chamber depth was measured and recorded after 3 days, 1 week and 1 month after surgery. Results Among the observation group, 3 days after surgery, IOP of 38 eyes was successfully controlled, IOP of 3 eyes was partially successfully controlled, with control rate as 100%; 1 week and 1 month after surgery, IOP of 37 eyes was successfully controlled, IOP of 3 eyes was partially successfully controlled, IOP of 1 eye was failed to control, with control rate as 97.56%. Among the control group, 3 days after surgery, IOP of 39 eyes was successfully controlled, IOP of 2 eyes was partially successfully controlled, with control rate as 100%; 1 week after surgery, IOP of 38 eyes was successfully controlled, IOP of 2 eyes was partially successfully controlled, IOP of 1 eye was failed to control, with control rate as 97.56%; 1 month after surgery, IOP of 37 eyes was successfully controlled, IOP of 2 eyes was partially successfully controlled, IOP of 2 eye was failed to control, with control rate as 95.12%. No significant difference was observed between two groups (P >0.05). Six eyes (6/41, 14.63%) had I degree shallow anterior chamber 3 days after surgery among the observation group, all recovered within 1 week without treatment, and remained stabilized 1 month after surgery; 12 eyes with shallow anterior chamber after surgery occurred in control group (12/41, 29.26%), significantly more than the observe group (χ2=18.76, P <0.01). Among them, 6 eyes had I degree shallow anterior chamber, 4 II degree shallow anterior chamber, and 1 III degree shallow anterior chamber. There were significantly more II and III degree shallow anterior chamber occurred in the control group (5/41, 12.19%) than observe group (0/41) (χ2=24.4, P <0.01). Eyes in the control group were recovered within 1-2 week after treatment, and stabilized after that. Conclusions Shoelace continu-ous suture for conjunctival incision can help preventing early stage postsurgical shallow anterior chamber. Key words: Shoelace continuous suture; Trabeculectomy; Anterior chamber