The benefits of phacotrabeculectomy using 10-0 polyglactin sutures

Abstract

Purpose. To determine the efficacy of a small scleral flap sutured with 10-0 polyglactin (Vicryl). Methods. One hundred and sixty-five eyes underwent clear cornea punch trabeculectomy under a 5.0 mm wide scleral flap that was closed with two 10-0 Vicryl sutures after phacoemulsification and insertion of a singlepiece PMMA lens. Complications, tonometric and visual results were assessed at regular intervals. Statistical analysis was by Fisher's exact test. Results. One hundred eyes that were followed for 1 year showed a mean intraocular pressure (IOP) of 14.7 mmHg, representing a fall of 36.5%. At 2 years the mean IOP was 16 mmHg (33 eyes). At final follow-up 87% had a corrected acuity of 6/12 or better and 96% had IOPs below 22 mmHg without additional medication. Complications included 11.5% fibrin reaction, 5.5% secondary hyphaema and 7.3% hypotony. There was a significant association of fibrin with both hypotony and pseudoexfoliation. Conclusions. These mid-term results show that 10-0 Vicryl compares favourably with other suture materials the results of which have been reported, and obviates the need for routine use of antimetabolites or for post-operative manipulations at the slit-lamp.