Laserable and releasable sutures preferable after trabeculectomy

Laser suture lysis or releasable suture techniques can be a preferable alternative to permanent sutures for closing scleral flaps in primary trabeculectomy with mitomycin C (MMC) in uncomplicated glaucoma, according to a study published in the March issue of Journal of Glaucoma.

The study, conducted by Dr Umit Aykan and colleagues, compared the efficacy and complication rates of laser suture lysis (LSL) or releasable suture techniques after trabeculectomy. The study analysed 48 eyes of 43 patients with uncomplicated glaucoma who were recruited for primary trabeculectomy with MMC. The patients were divided into two groups of 27 and 21 eyes that were randomly assigned to a standard surgery and releasable suture groups respectively. A target intraocular pressure (IOP) was determined on the basis of the severity of the glaucoma and was called a complete success, qualified success or failure.

Group 1 recorded a mean change in IOP after LSL of 7.31±1.98 mmHg, 6.1±1.1 mmHg and 3.9±1.5 mmHg when sutures were lysed on the first, second and third months, respectively. In group 2, the mean change in IOP after releasable suture removal was 8.20±2.74 mmHg, 5.12±1.65 mmHg and 4.4±1.0 mmHg, respectively. After six months, the success rates were 92% and 90% for LSL and releasable suture groups, respectively.

The study concluded that there is an effective IOP reduction in eyes that had suture release both in the early and late postoperative periods after LSL and suture release. Both the laserable and releasable suture techniques can therefore be preferred to permanent sutures for closing scleral flaps in primary trabeculectomy with MMC in uncomplicated glaucoma.