Modifications of trabeculectomy in glaucoma treatment

Purpose: to study efficacy of new trabeculectomy modifications for surgical treatment of primary open-angle glaucoma (POAG). Material and Methods. 49 patients with POAG (49 eyes) aged 51-73 years underwent modified surgery. The main technique of first new modification includes preparation of scleral flap, excision of trabecular tissue along the scleral spur, torsion of scleral flap for 180° and reposition of scleral flap in its original bed secured with interrupted nylon sutures (group 1). The main technique of second new modification includes preparation of scleral flap, excision of trabecular tissue, sewing of scleral flap in the middle with resorbable thread and tightening it into folds. Reposition and fixation of scleral flap and conjunctival flap closure completes the operation (group 2). The efficacy of new modifications of trabeculectomy was assessed during 12 months using complete ocular examination, optical coherence tomography of the anterior segment of the eye (ASOCT) in the early postoperative period and ultrasound biomicroscopy (UBM) subsequently. Results. One month after the surgery average intraocular pressure (ave. IOP) was 10.1±1,9 mmHg in group 1 and 11.2± 1.8 mmHg in group 2 (M±a). At 6 months this parameter was 12.6±3.0 mmHg (group 1) and 13,3±2,7 mmHg (group 2). At 12 months ave. IOP was 15.9±4.1 mmHg (group 1)and 17.3±2.7 mmHg (group 2). Conclusions. The newly developed modifications of trabeculectomy allow to obtain a prolonged hypotensive effect after surgical treatment of POAG.