ABSTRACT

Purpose

To define a modified flap suture approach and evaluate its effectiveness.

Methods

Clinical data of patients undergoing trabeculectomy with modified parallel suture technique (Group 1, N = 38 eyes) were compared to patients operated with classical flap suture technique (Group 2, N = 42 eyes). In the modified technique, two parallel sutures (one tight and one loose) are placed simultaneously in one of the flap corners with the aim of obtaining a safety stitch when the tight one needs to be cut. Data from preoperative and postoperative visits at day 1, week 1, months 1, 3, 6 and year 1 were recorded from patient charts and compared between the groups.

Results

In Group 1, seven eyes underwent laser suture lysis (LSL) between postoperative days 2 to 8 and in Group 2 two eyes at days 29 and 37. No complication related to LSL was observed. Rate of postoperative hypotony decreased with the parallel suture approach (P= .002). Number of eyes experiencing any of the complications related to hypotony was lower in Group 1 (P= .004). No significant difference was noted in the mean IOP between the groups (P> .05 for all).

Conclusion

The modified approach with parallel suture technique was found to be effective and safe. By enabling early LSL, it provided more precise IOP modulation in the early postoperative period. Thus, in our series, the rate of hypotony and hypotony-related complications decreased, while the success of the surgery was preserved.

中文翻译：

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平行缝合：实现早期激光缝合线溶解和预防小梁切除术后肌张力减退的简单方法

摘要

目的

定义改良的皮瓣缝合方法并评估其有效性。

方法

将采用改良平行缝合技术进行小梁切除术的患者（第 1 组，N = 38 只眼）与采用经典皮瓣缝合技术（第 2 组，N = 42 只眼）进行手术的患者的临床数据进行比较。在改进的技术中，两条平行的缝线（一条紧的和一条松的）同时放置在其中一个皮瓣角上，目的是在需要切断紧的缝线时获得安全缝线。从患者图表中记录第 1 天、第 1 周、第 1 个月、第 3 个月、第 6 个月和第 1 年的术前和术后访视数据，并在组间进行比较。

结果

在第 1 组中，7 只眼睛在术后第 2 天至第 8 天之间接受了激光缝合松解术 (LSL)，第 2 组中的两只眼睛在术后第 29 天和第 37 天接受了激光缝合松解术 (LSL)。没有观察到与 LSL 相关的并发症。平行缝合方法降低了术后低张力的发生率 ( P = .002)。第 1 组中出现与低眼压相关的任何并发症的眼睛数量较少（P = .004）。两组之间的平均眼压没有显着差异（P > .05）。

结论

发现采用平行缝合技术的改进方法是有效和安全的。通过启用早期 LSL，它在术后早期提供了更精确的眼压调节。因此，在我们的系列中，低眼压和低眼压相关并发症的发生率降低，而手术的成功率得以保留。