Abstract
BackgroundThe aim of this study was to compare the efficacy and tolerability of trabeculectomies performed with and without releasable sutures in the treatment of patients with uncontrolled glaucoma.MethodsA comprehensive literature meta-analysis was performed, comparing trabeculectomies performed with and without releasable sutures. The primary efficacy measure was the weighted mean difference (WMD) in percentage intraocular pressure reduction (IOPR%) at the follow-up end point. The secondary efficacy measure was the risk ratio (RR) for complete and qualified success rates of trabeculectomy at the follow-up end point. Trabeculectomy tolerability estimates were measured by the RR for adverse events. All the outcomes were reported with a 95% confidence interval (CI).ResultsThe WMD of the IOPR% from baseline was −4.56 (range −9.24–0.12) when trabeculectomies without releasable sutures were compared with trabeculectomies with releasable sutures. Trabeculectomies with releasable sutures were associated with numerically greater, but nonsignificant, efficacy in terms of lowered IOP compared with trabeculectomies without releasable sutures. The complete and qualified success rate of the two surgical procedures were comparable, with RRs of 0.92 (range 0.80–1.04) and 0.99 (range 0.89–1.11), respectively, at the follow-up endpoints. Trabeculectomies without releasable sutures were associated with a significantly higher frequency of hypotony and flat anterior chambers than trabeculectomies with releasable sutures, with pooled RRs of 4.04 (range 1.88–8.68) and 2.57 (range 1.25–5.30), respectively.ConclusionAlthough the two surgical procedures resulted in equivalent efficacy in IOP control, the trabeculectomies performed with releasable sutures were better tolerated than those without releasable sutures.
Highlights
The aim of this study was to compare the efficacy and tolerability of trabeculectomies performed with and without releasable sutures in the treatment of patients with uncontrolled glaucoma
Glaucoma is a major eye disease that tends to result in blindness, and trabeculectomy is currently considered an effective surgical procedure to treat uncontrolled glaucoma [1,2]
Trabeculectomy has been used for the treatment of glaucoma in clinical practice for over 40 years [3], several postoperative complications are associated with this procedure
Summary
The aim of this study was to compare the efficacy and tolerability of trabeculectomies performed with and without releasable sutures in the treatment of patients with uncontrolled glaucoma. Trabeculectomy has been used for the treatment of glaucoma in clinical practice for over 40 years [3], several postoperative complications are associated with this procedure. Trabeculectomy combined with releasable suture surgery has recently been used to treat uncontrolled glaucoma [7,8,9,10,11,12,13,14]. When the postoperative intraocular pressure (IOP) is elevated and decreases after massage, the sutures can be removed to increase the aqueous outflow. This technique is used in clinical practice today. Laser suture lysis may lead to conjunctival scars and a flat bleb [17]
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