[Risks of 360 degree suture trabeculotomy].

BACKGROUND

In 1995, Beck and Lynch reported a method to perform a 360 degrees trabeculotomy by prolene suture introduced into Schlemm's canal. Because this type of surgery has proved to have perils and can lead to extreme hypotony, even a small series of cases must be reported.

PATIENTS: Suture trabeculotomy was planned in five eyes of four patients, 5 and 7 months old and 6 and 51 years old, with primary congenital glaucoma, but completed in only two eyes.

RESULTS

In one child, suture trabeculotomy could be accomplished easily in both eyes. In the first eye a 360 degrees-tomy was performed, in the second eye only a 180 degrees-tomy was done. Both eyes remained extremely hypotonic (4 mm Hg). In one eye Schlemm's canal could not be disrupted by the suture; in another eye, Schlemm's canal could be probed only for a short distance, and in one eye the suture went the wrong way.

CONCLUSIONS

Because a suture trabeculotomy can be transformed into a normal trabeculotomy any time, the main problems of the 360 degrees-suture trabeculotomy are not the possible technical difficulties, but that a successful suture trabeculotomy is followed by extreme hypotony.