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Cross technique most effective in preventing leakage in trabeculectomy, study finds
Arch Ophthalmol. 2008;126(12):1756-1758.
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A study comparing a parallel technique, a cross technique and a no block suture technique for patients undergoing trabeculectomy found that the cross technique had no leakage, while both the parallel technique and surgery without block suture cases had leaks.
Clinicians performed trabeculectomy with mitomycin C in 153 glaucomatous eyes using fornix-based conjunctival flaps. Of those eyes, 44 underwent surgery without block suture, 51 underwent the parallel technique, and 58 underwent the cross technique. Patients in all three groups had a variety of glaucoma types, including primary open-angle, normal tension, neovascular, exfoliation and uveitic.
Of the 44 eyes that had surgery without block suture, aqueous leakage occurred in four eyes (9%); in the 51 eyes with the parallel technique, one eye (2%) had leakage from the limbus incision; and in the 58 eyes that had the cross technique, there were no detected cases of leakage.
"The parallel technique was also effective to stop an aqueous leakage but not as effective as the cross technique because the suture in the cross technique can follow the curvature of the cornea and therefore exert more direct pressure on the conjunctiva flap then the parallel technique," the study authors said.