Timing of scleral flap suture release affects complication rates

Performing a scleral flap suture release 3 weeks after phacotrabeculectomy can result in a greater long-term success with fewer complications, according to a study.

Mark S. Juzych, MD, MHSA, and colleagues studied 173 eyes of 173 consecutive patients with primary open-angle glaucoma who underwent primary phacotrabeculectomy, with or without mitomycin C (MMC), and who subsequently underwent scleral flap suture release. Intraoperative MMC was used in 102 eyes.

When patients underwent scleral flap suture release less than 3 weeks after the initial surgery, they had a lower long-term success rate than patients who underwent the release procedure 3 weeks or more after the initial surgery, according to the study. The overall follow-up was 44.8 months.

At 4 years, the mean success rate for early suture release was 15%; for late suture release, the success rate was 22%.

Statistically, patients who were given MMC had later suture releases than those who did not have MMC, the researchers said. Nine cases of hypotony were reported; all those patients had received MMC. Eight of the nine cases of hypotony underwent early suture release as well, the researchers said.

The study is published in the April issue of American Journal of Ophthalmology.