Fornix-based Trabeculectomy With Mitomycin C Using the Horizontal Conjunctival Suture Technique

Abstract

The aim of this study was to determine the safety, efficacy, and bleb morphology of fornix-based trabeculectomy with mitomycin C using the horizontal suture technique. A retrospective noncomparative case series of 79 eyes of 69 patients, who underwent fornix-based trabeculectomy with mitomycin C, was studied. Conjunctival closure of all eyes was with the horizontal suture technique using 10-0 nylon suture to prevent bleb leakage and improve bleb morphology posttrabeculectomy. The main outcome measures were the bleb morphology, outcome of surgery, and complications posttrabeculectomy. At a mean follow-up period of 25.5±9.3 months, 65 eyes (82.3%) had diffuse blebs with horizontal extent between 2 and 4 clock hours. Low-lying bleb was found in 35 eyes (44.3%), whereas 39 eyes (49.4%) had moderately elevated bleb. Fifty-one eyes (64.6%) had complete success, 18 eyes (22.8%) had qualified success, whereas 10 eyes (12.6%) were classified as treatment failures. Overall, 87.4% of the patients had a successful outcome. Corneal encroachment/overhanging blebs were found in 3 eyes (3.8%). Bleb leakage was found in 7 eyes (8.8%). There was overfiltration in 2 eyes (2.5%) with shallow anterior chamber. The horizontal suture technique is an easily applied, less time-consuming technique that gives excellent bleb morphology with few complications in the long term.