Resuturing scleral flap reverses hypotony from overfiltration after trabeculectomy
Transconjunctival resuturing of the scleral flap was successful in treating hypotony maculopathy after trabeculectomy, according to a study.
Several 10-0 nylon sutures on a cutting needle were stitched through the conjunctiva and into the scleral flap, reattached to the adjacent sclera and knotted over the conjunctiva. A tight suture was used to raise the postoperative IOP and flatten macular folds.
The retrospective study included 53 cases with hypotony due to overfiltration. Flap suturing was performed a mean 2 months after trabeculectomy.
Mean preoperative IOP was 3.55 mm Hg and increased to 20.08 mm Hg 1 day after surgery; the increase was statistically significant (P < .05). Mean IOP was 10.69 mm Hg at 1 month, 9.87 mm Hg at 3 months, 10.12 mm Hg at 6 months, 9.85 mm Hg at 1 year, 10.42 mm Hg at 2 years and 9.5 mm Hg at 4 years.
Mean logMAR visual acuity improved significantly, from 0.8 before surgery to 0.5 at 1 month after surgery (P < .05), the authors said. It was maintained at 0.3 from 3 months through 4 years.