Abstract
Purpose: :
The purpose of this study is to compare the safety and efficacy of fibrin tissue adhesive to suture conjunctival fornix–based flap wound closure in trabeculectomy surgery.
Methods: :
This is a comparative interventional review of the most recent 38 patients that underwent combined cataract extraction surgery and trabeculectomy surgery with 6 months of follow–up. 18 eyes of 18 patients with fibrin tissue adhesive conjunctival flap closure are compared to 20 eyes of 20 patients who underwent the same procedure except with suture conjunctival flap closure. Patient demographics, surgical times, pre– and post–operative intraocular pressure (IOP), glaucoma medications, intraoperative and postoperative complications such as wound leaks and bleb dysesthesia were recorded and compared.
Results: :
There were no significant differences in the age, postoperative IOP and number of medications pre– and post–operatively (P > 0.05). In the suture group, the IOP decreased from 18.7 ± 0.87 (mean (mmHg) ± standard error) with 2.80 ± 0.20 medications preoperatively to an IOP of 13.0 ± 0.61 with 0.75 ± 0.22 medications six months postoperatively. In the tissue adhesive group, the IOP decreased from 16.3 ± 0.70 with 3.11 ± 0.18 medications preoperatively to an IOP of 12.5 ± 0.73 with 0.50 ± 0.27 medications six months postoperatively. The number of bleb leaks (3) was equal in each group.
Conclusions: :
In this interventional review of patients with glaucoma and cataracts, fibrin tissue adhesive compared to suture conjunctival wound closure in combined cataract extraction surgery and trabeculectomy procedures represents an equally effective technique with comparable postoperative IOP and bleb leaks and with the advantages of less postoperative discomfort and shorter operating times.
Keywords: trabecular meshwork • wound healing • intraocular pressure