Purpose: To report on the surgical outcome after at least 12 months of follow-up of initial mini-trabeculectomy (without radial incisions), a modification of the Cairns’ trabeculectomy.
Methods: In a prospective study, initial mini-trabeculectomy was performed on 41 eyes of 41 consecutive patients aged ³40 years old. The surgical procedure refers to a 3-mm fornix-based conjunctival flap, sclerostomy at 1-mm from the limbus and a sclerocorneal tunnel without radial incisions. Of the 41 eyes, one eye underwent intraocular operation 5 months postoperatively and therefore was evaluated only for surgical complications. Thirty-six eyes have completed ³12 months of follow-up and were included in the mid-term calculations of IOP control.
Results: Mean preoperative intraocular pressure (IOP; n=36) was 30.2±9.3 mmHg (range, 19-54) with 3.0±1.2 hypotensive medications (1-4). After 12–43 months (mean, 25.0±9.2) of follow-up, IOP was £20 mmHg in 35 eyes (97.2%; P<0.0001) and the mean IOP was 16.0±2.8 mmHg (11-21) with 0.8±1.0 hypotensive medications (0-3). Postoperative complications in the 37 eyes included early postoperative aqueous leakage with moderately shallow or deep anterior chamber in two (5.4%) eyes and rapid cataract progression in one (2.7%) eye.
Conclusions: Initial mini-trabeculectomy was found efficacious and relatively safe after mid-term of follow-up. The relatively small peritomy, the tunnel approach and the avoidance of radial incisions seem to offer clinical and technical advantages over the standard trabeculectomy. A controlled study is required to confirm these observations.