Safety and Efficacy of Single-site Phacotrabeculectomy With Mitomicin C Using Nylon and Polyglactin Suture for Scleral Tunnel Closure.

PURPOSE

To evaluate the efficacy of polyglactin use along with nylon suture in scleral tunnel closure after single-site phacotrabeculectomy.

METHODS

This retrospective case series included 139 eyes of 139 patients who had scleral tunnel closure with 1 polyglactin and 1 nylon suture after single-site phacotrabeculectomy with a low dose of mitomycin C between 2002 and 2005. The intraocular pressure (IOP), the visual acuity, the number of glaucoma medications, postoperative complications, and interventions were the outcomes measured.

RESULTS

The majority of them had primary open-angle glaucoma (93 eyes, 67%), 93 eyes (67%) had severe glaucomatous optic neuropathy, and 77 eyes (55.3%) had severe visual-field loss. The IOP decreased from a mean preoperative value of 18.1±5.3 mm Hg on a mean number of 1.8±0.8 glaucoma medications to mean IOPs of 13.3±4.6, 14.0±4.3, and 11.8±3.9 mm Hg on a mean number of 0.2±0.6, 0.3±0.7, 0.5±1.0 glaucoma medications (P<0.001) at 1-, 3-, and 5-year follow-up visits, respectively. An IOP of <21 mm Hg with or without medication was achieved in 96±2% at 1 year, in 88±4% at 3 years, and in 73±8% at 5 years. Shallow anterior chamber was the most common early postoperative complication (3 eyes, 2.1%). Nylon suturelysis with laser was performed in 16 eyes (11.5%).

CONCLUSIONS

The technique used here seems to be effective in controlling the IOP and has very minimal associated complications.