Trabeculectomy with Releasable Sutures. (Early and Late Level of IntraocularPressure)

Overview

Purpose:
To evaluate the level of IOP and clinical status the first day aftertrabeculectomy (TE) with releasable sutures (RS), to follow up the extraction ofRS in correlation with early and late postoperative level of IOP.Methods: In a retrospective study, 40 patients with open angle glaucoma werefollowed. They underwent TE with two RS on both eyes.Results: Hypotony (IOP less than 6 mmHg) was noted in 15 eyes (19 %) the firstday after the operation, shallow anterior chamber in 5 (6 %). An IOP level higherthan 20 mmHg was found in 11 eyes (13 %) one day after surgery.No RS were extracted in the first group of 26 eyes. The early mean IOP was 10,15± 7,1 mmHg the 1stday after surgery. IOP increased to a mean level of 15,3 ± 3,8mmHg two years after TE, 65 % of eyes were without glaucoma therapy. One RSwas extracted in the second group of 28 eyes. The early mean level of IOP was 10,7± 6,5 mmHg, the late level 13,9 ± 3,7 mmHg. The target pressure was maintainedin 68% of the eyes without additional glaucoma therapy. The third group had 26eyes and two RS were extracted after TE. The early mean level of IOP was 14,7 ±6,9 mmHg, the mean level of IOP was 15,8 ± 3,9 mmHg two years after surgery,39 % of eyes were without glaucoma therapy. Conclusion: A level of IOP the first day after the operation, lower than 6 mmHgor higher than 20 mmHg, must not be an indicator for failure of the surgery.Observing the level of IOP 3 - 5 days after surgery determines whether the RS isto be removed or not. The use of RS prevents short-term complications and theextraction of RS during the postoperative period can positively influence theevaluation of filtration.

Key words:
early intraocular pressure, late intraocular pressure, releasable sutu-res, target pressure, trabeculectomy