Purpose: To determine whether argon laser suture lysis affects the success rate of mitomycin-C trabeculectomy as well as the incidence of short term complications.
Methods: Thirty-four eyes with uncontrolled primary open angle glaucoma underwent trabeculectomy with mitomycin-C. the scleral flap was tightly closed with seven 10-0 nylon sutures. postoperatively, 28 of these eyes underwent laser suture lysis of the scleral flap sutures because intraocular pressure was higher than 15 mmHg or the filtering bleb was flat. six eyes did not require lysis because the intraocular pressure was less than 15 mmHg and the filtering bleb was active.
Results: the interval from surgery to laser suture lysis ranged from 2 to 21 days. the number of lysed sutures needed to achieve the target intraocular pressure ranged from 1 to 4 sutures. the mean intraocular pressure was 25.4 ± 5.7 mmHg before and 10.1 ± 4.5 mmHg after laser suture lysis. hyoptony (Intraocular pressure < 6 mmHg) developed in eight eyes, and resolved spontaneously in seven eyes within 1 week. one eye required surgical intervention to reform a persistent flat anterior chamber.
Conclusion: Argon laser suture lysis following mitomycin-C trabeculectomy is a safe and effective method of controlling intraocular pressure, while minimizing hyoptony and other complications related to excessive filteration. |
