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Y.–P.K. Lin, D. Zurakowski, R.S. Ayyala; Traditional Limbal–Based Trabeculectomy versus Fornix–Based Trabeculectomy With Corneal Valve: Surgical Outcomes . Invest. Ophthalmol. Vis. Sci. 2005;46(13):89.
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Purpose: To compare the safety and efficacy of the fornix–based trabeculetomy with corneal valve and the traditional limbal–based trabeculectomy. Methods: Retrospective review of 42 eyes from 31 patients who underwent limbal–based trabeculectomy with mitomycin C and 34 eyes from 25 patients who underwent fornix–based trabeculectomy with cornea valve with mitomycin C was performed. The limbal group underwent traditional operation with placement of a single mitomycin–C sponge (0.4 mg/cc) under the conjunctiva and scleral flap followed by trabeculectomy whereas the fornix group had two mitomycin–C soaked sponge pieces (0.4 mg/cc) placed under the conjunctiva posteriorly and one placed under the corneoscleral flap followed by keratectomy instead of a trabeculectomy. All surgeries were performed by a single surgeon (RSA) between 12/1999 and 11/2003 with a minimum of 12 months follow up. Eyes with previous intraocular surgery were excluded. Results: There were no significant differences in the age, sex, diagnosis, the number of pre and post operative medications and IOP, and duration of mitomycin–C application between the two groups. The mean intraocular pressure decreased from 23 ± 12 mmHg pre–operatively to 12 ± 5 mmHg 12 months post–operatively in the limbal–based group and from 24 ± 10 mmHg pre–operatively to 11 ± 3 mmHg 12 months post–operatively in the fornix–based cornea valve group. There was a trend towards lower incidence of shallow anterior chamber ( 38% vs 29%), and choroidal effusions ( 38% vs 24%) among the fornix based group. Diffuse posterior blebs were more likely among the fornix based operations (70% vs 45%). Conclusions: Fornix–based corneal valve trabeculectomy is an effective technique that results in comparable IOP and diffuse posterior blebs.
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