This article is more than 5 years old. Information may no longer be current.
Resuturing scleral flap reverses hypotony from overfiltration after trabeculectomy
Transconjunctival resuturing of the scleral flap was successful in treating hypotony maculopathy after trabeculectomy, according to a study.
Several 10-0 nylon sutures on a cutting needle were stitched through the conjunctiva and into the scleral flap, reattached to the adjacent sclera and knotted over the conjunctiva. A tight suture was used to raise the postoperative IOP and flatten macular folds.
The retrospective study included 53 cases with hypotony due to overfiltration. Flap suturing was performed a mean 2 months after trabeculectomy.
Mean preoperative IOP was 3.55 mm Hg and increased to 20.08 mm Hg 1 day after surgery; the increase was statistically significant (P < .05). Mean IOP was 10.69 mm Hg at 1 month, 9.87 mm Hg at 3 months, 10.12 mm Hg at 6 months, 9.85 mm Hg at 1 year, 10.42 mm Hg at 2 years and 9.5 mm Hg at 4 years.
Mean logMAR visual acuity improved significantly, from 0.8 before surgery to 0.5 at 1 month after surgery (P < .05), the authors said. It was maintained at 0.3 from 3 months through 4 years.