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Comment on rotational lamellar scleral flap technique
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To the Editor:
We read with interest the article “Rotational lamellar scleral flap technique useful for bleb leak,” published in the Feb. 10, 2010, issue of Ocular Surgery News (page 33). We note that the authors said this is a new technique. We want to bring to your attention that this technique has been published by us as “Scleral rotation flap: an alternative to approach to a leaking filtration bleb” in the August/September 1998 issue of the CME Journal Ophthalmology.
We agree that the scleral lamellar flap can be rotated to cover the dehiscence and give a good outcome after surgery. We used 8-0 virgin silk to suture, and the authors used 10-0 nylon sutures. Both sutures are nonabsorbable sutures. At the time we published the article, silk was the most common nonabsorbable suture used.
In conclusion, we agree that rotational scleral flap has a better outcome than donor scleral patch graft, and larger clinical studies with longer follow-up are needed.
Harpreet Ahluwalia, MBBS, MS, MRCOphth, FRCS, FRCOphth
Consultant ophthalmologist at University Hospital of Coventry and
Warwickshire and associate clinical professor, Warwick University
Jaishree Gandhewar, MBBS, DNB, MRCOphth, MRCS, FRCS
University Hospital of Coventry and Warwickshire
J.L. Aggarwal, FRCS, FRCOphth
Retired
consultant ophthalmologist
Reference:
- Aggarwal JL, Ahluwalia HS. Scleral rotation flap: an alternative approach to a leaking filtration bleb. CME J Ophthalmol. 1998;2(2):52-53.
The authors respond:
We would like to congratulate Ahluwalia and colleagues for their work in the scleral rotational flap technique and also for their interest in reading our article in Ocular Surgery News. We did our literature search in PubMed, ScienceDirect and online peer-reviewed journals before publishing our manuscript in OSN. We could not get an article cited as rotational scleral flap in the above literature search. Hence, we did not have the opportunity to read their work, which was published in CME Journal Ophthalmology in 1998. It is nice to know that Ahluwalia and colleagues have done a similar procedure using 8-0 virgin silk. We have planned for a long-term follow-up study in these eyes.
Dhivya Ashok Kumar, MD, Soosan Jacob, MS, FRCS, and
Amar Agarwal, MS, FRCS, FRCOphth
Dr. Agarwal’s Eye Hospital