Glaucoma surgery is still mainly directed towards lowering
intraocular pressure. Target pressure being difficult to establish as a certain
value, different surgical procedures were established. Reading about a new
method of suturing the scleral flap in a removable-suture trabeculectomy
technique, presented in “Ophthalmologie” 1998 no. 12 “Nouvelle méthode de suture dans la trabéculectomie” by R.
Meduri, L. Scorolli, G. Savini, G.L. Laffi, I began to operate all my cases
with this procedure. The study presents a comparison between three groups; one
is operated with removable-suture trabeculectomy – Group I, one is operated
with standard trabeculectomy (Cairns) – Group II, and one is the group reported
by the article mentioned above – Group III. Medium pre-operative intraocular
pressures were as reported: 34,95±13,64
mmHg in Group I, 31,41± 10.61mmHg
in Group II and 25,7±5,4 mmHg in
Group III. Immediate post-operative intraocular pressures were: 5,97±5,1 mmHg in Group I, 12,37±4,74 mmHg in Group
II, and 10,2±5,9 mmHg in Group III. At four months the results are as follows:
12,93±3,82 mmHg in Group I, 18,56±6,23 mmHg in Group II, and 14,4±6,3 mmHg in
Group III. Unlike the Italian authors, who reported removing the suture to all
operated cases within 4 to 11 days post-operatively, I was forced to remove the
suture in only 7 cases within 10 to 24 days post-operatively. Complication rate
was roughly similar. I believe that the technique should be used in cases with
pre-operative pressures around 30-35mmHg and target pressures around 12-15mmHg.