A novel suturing technique for filtering glaucoma surgery: The accordion suture

Abstract

AIM: To present a novel scleral flap suturing technique for filtering glaucoma surgery in order to control high postoperative intraocular pressure (IOP). METHODS: Description of 'the accordion suture' technique for mitomycin C augmented trabeculectomy. In cases of postoperative high IOP, pulling the loop of the suture helps to lift up the scleral flap by an even pressure on both edges. By means of this technique, the scleral flap opens up in an "accordion'' manner, thus preventing flap obstruction and providing adequate aqueous flow. RESULTS: Our study group consisted of 8 eyes of 8 patients with neovascular glaucoma. Mean age of the subjects was 67.42 +/- 8.21y and female/male ratio was 4/4. Mean preoperative IOP was 37 +/- 7.48 mm Hg. Mitomycin C augmented trabeculectomy was carried out on the subjects without any complications. The scleral flap closure is performed with three separate sutures; initially, our accordion suture through the center of the flap, and two releasable sutures on both corners. All the patients received removal of two side releasable sutures concomitant with pulling the accordion suture, without any complications. The average traction time was 3.5 +/- 0wk postoperatively. The mean postoperative IOP was 11.37 +/- 2.72 mm Hg. No suture related complications were observed. CONCLUSION: This technique can be the suture of choice for filtering glaucoma surgery in experienced hands by its easy learning curve for precisely indicated patients.