Resuturing the scleral flap through conjunctiva for treatment of excess filtration

Flap suture - a simple technique for the revision of hypotony maculopathy following trabeculectomy with mitomycin C

“…Meanwhile, Shirato et al [15] described a similar method using only one or two 10.0 nylon sutures in ten eyes with hypotony. Mean IOP 1 week after surgery was 8 mmHg and 8.2 mmHg at 2 to 15 months postoperatively.…”

Shallow Anterior Chamber After Trabeculectomy

“…No perioperative complications were reported. 29 Eha and coworkers resutured the scleral flap through the intact conjunctiva with an additional 10.0 nylon suture, without opening the conjunctiva. These authors achieved full success in 16 consecutive patients with hypotony maculopathy, after trabeculectomy with mitomicin.…”

Efficacy and safety of transconjunctival scleral flap resuturing for hypotony after glaucoma filtering surgery

“…1) [39]. After applying 5% providone (Isodine) for disinfection and 4% lidocaine ophthalmic solution (Xylocaine 4%) for anesthesia, the following procedures were conducted under slit-lamp microscopy.…”

“…However, none of the above methods decreases the effects of excess filtration or resolves hypotony with high reliability and safety. Shirato and others [39] reported a method of resuturing the scleral flap directly through the conjunctiva (transconjunctival scleral flap resuturing; TCSFR) without reopening the conjunctiva as a simple and effective, minimally invasive technique for the treatment of hypotony. In the present study, we conducted TCSFR on patients with hypotony due to excess filtration after glaucoma filtering surgery, and evaluated the efficacy and safety of this method by assessing its intraocular pressure (IOP) increasing effect, the best-corrected visual acuity, the success rates for resolving hypotony maculopathy and choroidal detachment, the rate of complications, and the requirement for supplemental surgical treatment.…”