A randomised clinical trial comparing the outcome of trabeculectomy using triangular versus rectangular scleral flaps.

Abstract

trabeculectomy is the standard surgical procedure for management of glaucoma. to compare the outcome of triangular and rectangular scleral flaps in trabeculectomy. this study was carried out in the Department ofOphthalmology, BPKIHS, Dharan, over a period of one year. A total of 22 patients undergoing trabeculectomy were randomized to undergo either trabeculectomy with triangular scleral flap (Group A= 11 eyes) or trabeculectomy with rectangular flap (Group B = 11 eyes). OUTCOME MEASUREMENT: the parameters studied were intraocular pressure (IOP), anterior chamber depth (ACD), bleb characteristics and surgical complications. P value of<0.05 was considered significant. All calculations were executed using SPSS 11.0 software program. the age ranged between 40 to 76 years with the mean of 56.5 +/- 9.25 years. The most common preoperative diagnosis was angle closure glaucoma. The postoperative percentage of IOP reduction (Group A=68.9%; Group B=66.51%) was statically significant in both the groups (p=0.001). Trabeculectomy was almost equally effective with complete surgical success of 91% in group A, and 82% in group B (p=0.534). Final bleb scores were almost similar in both the groups with 3.27 +/- 1.5 in group A and 3.36 +/- 1.21 in group B (p=0.877). Hypotony with the IOP less than 6 mmHg was found in the first post-operative day in 2 patients in Group A and in 1 in Group B. All of them improved spontaneously within a week. both triangular and rectangular scleral flaps in trabeculectomy are equally effective in terms of post surgical IOP control, bleb characteristics and complications.