Laser Suture Lysis or Releasable Sutures After Trabeculectomy

Aykan, Ümit; Bilge, Ahmet Hamdi; Akın, Tuğrul; Certel, İsmail; Bayer, Atilla

doi:10.1097/ijg.0b013e31802d6ded

Cited by 36 publications

(28 citation statements)

References 21 publications

(24 reference statements)

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“…The resistance of suture still remains unless it is totally relaxed. Indeed in one of our cases, a choroidal detachment was However, risk of hypotony due to released suture and suture exposure complications such as foreign body irritation, keratopathy, and endophthalmitis may be associated with releasable sutures and/or ASL [9,[11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

The effect of adjustable suture (Khaw) trabeculectomy on intraocular pressure: a retrospective case series

2015

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The aim of the study is to investigate long-term intraocular pressure (IOP) outcome as well as complications associated with adjustable suture trabeculectomy in glaucoma patients who were uncontrolled under maximum medical therapy. In this retrospective case series, 35 eyes of 30 patients are included in the study. Adjustable suture trabeculectomy with 0.2 mg/cc mitomycin-C for 3 min was performed by the same surgeon. Subconjunctival 5-fluorouracil injection, transconjunctival suture adjustment, digital massage, and/or argon suturolysis were utilized postoperatively as needed. Complete success, qualified success, and failure were defined as IOP ≤ 18 mmHg without medication, IOP ≤ 18 mmHg with one or more medications, and IOP >18 mmHg with medication or need for additional glaucoma surgery, respectively. Of the 35 eyes, 13 had primary open angle, 18 had psuedoexfoliative, 1 had juvenile, 1 had pigmentary, 1 had uveitic, and 1 had chronic angle-closure glaucoma. Mean preoperative IOP of 30.1 ± 10.5 mmHg dropped to 10.8 ± 4.7 mmHg (p < 0.001) after a mean follow-up of 595 ± 435 days. Nine eyes had the desired IOP on first postoperative day where no transconjunctival suture adjustment was performed. Remaining 26 eyes required a mean of two adjustments (range 1-7) during the first postoperative 24 days in order to achieve a desirable IOP. Complete success, qualified success, and failure were observed in 28 (80 %), 5 (14 %), and 2 (6 %) eyes, respectively. There were no serious complications related to adjustable suture trabeculectomy. We believe adjustable suture trabeculectomy to be a safe and effective alternative to standard trabeculectomy where a desirable low IOP can be achieved.

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Section: Discussionmentioning

confidence: 99%

The effect of adjustable suture (Khaw) trabeculectomy on intraocular pressure: a retrospective case series

2015

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“…3 gevşetme tekniği kullanılabilir ya da minimal invaziv bir yöntem olan termal LSL tekniği kullanılabilir. 7,[9][10][11][12][13][14][15] LSL tekniği ile uzun dönem GİB kontrolünden ödün vermeden, cerrahi sonrası erken dönem aşırı filtrasyon komplikasyonlarından korunulmuş olmaktadır.…”

Section: Discussionunclassified

Trabekülektomi Sonrası Erken Dönem Yüksek Göz İçi Basıncında Lazer Sütür Lizisin Etkinliği

Şatana¹,

Kocasaraç²,

Altan³

et al. 2013

Tjo

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Amaç: Trabekülektomi sonrası göz içi basıncı (GİB) yüksek seyreden hastalarda lazer sütür lizisin etkinliğini değerlendirmek. Ge reç ve Yön tem: Temmuz 2009-Şubat 2011 tarihleri arasında kliniğimiz glokom biriminde trabekülektomi uygulanmış, postoperatif GİB yüksek seyreden, masajla bleb oluşturulabilen, 22 hastanın 22 gözüne argon lazer sütür lizis uygulandı. So nuç lar: Olguların ortalama yaşı 62,7±10,8 (38-77) ve kadın/erkek oranı 11/11 idi. Lazer sütür lizis ile trabekülektomi arasındaki geçen süre ortalama 18,5±31,1 gün (2-50 gün) idi. Sütürlizis öncesi ve sütür lizisten hemen sonra ölçülen ortalama GİB sırasıyla 25±8,6 mmHg (14-45 mmHg) ve 14±5,8 mmHg idi (6-27 mmHg) (p<0,001). Olguların son muayenesindeki ortalama GİB 13,5±3,4 mmHg idi (6-26 mmHg) (p<0,001). Olguların ortalama takip süresi 6,1±3,4 (3-13 ay) aydı. Tar t›fl ma: Lazer sütür lizis, trabekülektomi sonrası hedef GİB'na ulaşılamayan olguların tedavisinde etkili ve güvenli bir yöntemdir. (Turk J Ophthalmol 2013; 43: 91-3) Anah tar Ke li me ler: Trabekülektomi, lazer sütür lizis, GİB Sum maryPur po se: To evaluate the effectiveness of laser suture lysis in patients with high intraocular pressure (IOP) after trabeculectomy. Ma te ri al and Met hod: We evaluated retrospectively 22 eyes of 22 patients who had undergone trabeculectomy followed by laser suture lysis due to high IOP between July 2009 and February 2011. The process was performed in patients who had high IOP with bleb formation after ocular massage in early postoperative period. Re sults: The mean age was 62.7±10.8 (38-77) years and the male/female ratio was 11/11 in the study group. The mean interval time between trabeculectomy and performance of suture lysis was 18.5 ±31.1 days (2-150 days). The mean IOPs before and immediately after laser suture lysis were 25 ±8.6 mmHg (14-45 mmHg) and 14±5.8 mmHg (6-27 mmHg), respectively (p<0.001). At the last visit, the mean IOP was 13.5±3.4 mmHg (6-26 mmHg) (p<0.001). The mean follow-up time was 6.1±3.4 months (3-13 months). Dis cus si on: Laser suture lysis is a safe and effective method in the management of the patients in whom the target IOP was not reached after trabeculectomy. (Turk J Ophthalmol 2013; 43: 91-3)

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“…However, suture removal or lysis may cause further complications like conjunctival hole with aqueous leak, sudden hypotony, shallow anterior chamber, malignant glaucoma and inflammation or may be unsuccessful due to thick overlying conjunctiva or blood over sutures. [2,3,4,5] Another technique which is being used to overcome the complications of conventional trabeculectomy is use of releasable sutures. This technique results is titrated outflow of the aqueous, thus preventing early postoperative hypotony and shallow anterior chamber.…”

Section: Discussionmentioning

confidence: 99%

“…Conjunctival perforation, sudden hypotony, shallow anterior chamber and malignant glaucoma have been reported after laser suture lysis. [2,3,4,5 ] and may not be possible in case of thick tenon and subconjunctival haemorrhage.…”

Section: Introductionmentioning

confidence: 99%