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Systematic laser suturolysis in post‐operative management in trabeculectomy – early results from pilot study
Author(s) -
Mano S.,
Nuno P.F.,
Marques R.E.,
Abegão Pinto L.
Publication year - 2017
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2017.03561
Subject(s) - medicine , trabeculectomy , intraocular pressure , glaucoma , dry needling , ophthalmology , surgery , prospective cohort study , glaucoma surgery , alternative medicine , pathology , acupuncture
Purpose The early stages of a filtering surgery are usually associated with a number of procedures aimed at sustaining an optimal aqueous humour drainage. One option is to decrease the resistance to outflow by laser suturolysis of the scleral flap. We aim to explore the early effects of systematic suturolysis in efficacy and safety in post‐operative trabeculectomies. Methods Prospective interventional study enrolling patients undergoing primary trabeculectomies with mytomicinc C (0.4 mg/ mL ) for open angle glaucoma. A protocol in which suturolysis were done routinely if intraocular pressure greater than 10 mmHg starting at day 8 post‐operative. Only one suturolysis was done at each visit. Intraocular pressure (IOP) ‐ lowering efficiency of each suturolysis was assessed. Safety parameters were also analyzes. Results Thirty‐one eyes of 27 patients (13 males) were enrolled with a mean age of 68 years. Pre‐operative pressure was 25 mmHg. Twenty‐nine patients underwent a suturolysis on day 8, with an IOP ‐lowering efficacy of 36%. A second suturolysis, when performed (n = 17), had an additional IOP lowering of 27%. At 1 month, 3.2%, 96.8% and 51.6% of patients had 0, 1 or 2 suturolysis, respectively. Mean IOP at this period was 12.93 mmHg. During this period, there were 2 patients with choroidal detachments, and 9 patients needed an additional bleb needling with 5‐fluorouracil (5‐ FU ).