Short-Term Outcomes of a Modified Safer Surgery Trabeculectomy Technique

Abstract

Abstract Purpose: To determine the short-term outcomes of a modified Moorfields Safer Surgery System technique of trabeculectomy. Methods: This is a prospective interventional study. Trabeculectomy was performed according to the author’s modification of Moorfields Safer Surgery System. This method allows titrating the opening pressure of trabeculectomy by varying the side cuts, varying the ostium size, and adjusting the tightness of the sutures. Forty-four eyes of 43 patients were included. Main outcome measures include postoperative intraocular pressure (IOP), incidence of intra and postoperative complications, and success up to 6 months after surgery. Results: The mean preoperative and postoperative IOP at 6 months were 20.97 ± 7.93 mmHg and 12.69 ± 4.76 mmHg, respectively (n = 44). 70.5% of the patients had absolute success at 6 months, and the overall success was 88.6%. None of the patients had hypotony and there were no intraoperative complications noted. Forty-two out of 44 eyes (95.5%) had diffuse formed blebs without leak on the 1st postoperative day. The most common postoperative complication (13.6%) was a conjunctival leak that was detected on fluorescein staining. In all these patients, the anterior chamber was deep, and the bleb well formed. These leaks were resolved with conservative measures. Many of these leaks would have been missed if not intentionally looked for. Excluding this complication, we had a complication rate of 9.1%. Conclusion: The authors’ modification of the Moorfields Safer Surgery System technique may allow the surgeon to optimize aqueous flow through trabeculectomy while mitigating complications.