Small incision trabeculectomy avoiding tenon´s capsule: two years minimum follow-up

Fabian Lerner, Ignacio Lischinsky and Ricardo Masini

University of Buenos Aires, Argentina

Purpose: To evaluate the two-years minimum follow-up results of a recently described trabeculectomy technique (Ophthalmology 1997; 104: 1237-1241), which is performed through a 1.75 mm incision, and minimizes trauma to Tenon´s capsule.

Methods: A prospective evaluation of small-incision trabeculectomy avoiding Tenon´s capsule was performed of 41 eyes (39 patients). All eyes had 2 years minimum follow-up. 23 eyes also had 3 years follow-up. 5-FU was used intra and/or postoperatively in patients with high risk for failure. Success was defined as IOP < 16 mmHg with more than 30% reduction of the preoperative IOP.

Results: Intraocular pressure decreased from 35.53 + 10.41 mmHg preoperatively to 10.53 + 3.45 mmHg at two years (p<.001), and 11.09 + 3.03 mmHg at three years (p<.001). 5-FU was used in 22 eyes. Success was achieved in 39/41 eyes (95.12%) at two years, two of them with medication. Complications included immediate postoperative conjunctival leakage (9 eyes), shallow anterior chamber (6 eyes), choroidal detachment (3 eyes) and epithelial keratopathy (1 eye). No loss of more than one line of visual acuity was found, except for two eyes that required cataract extraction.

Conclusions: Small incision trabeculectomy avoiding Tenon´s capsule was safe and effective in achieving an IOP < 16 mmHg at two years.