Merits of conjunctival frill incision in reducing trabeculectomy-induced astigmatism and patient discomfort.

PURPOSE: To compare results of a novel "conjunctival frill/smile incision" on surgically induced astigmatism (SIA) and patient discomfort vs conventional trabeculectomy in the initial postoperative period.

METHODS

Sixty trabeculectomy cases were subjected to either conjunctival frill incision, performed 1.5-2.0 mm from the limbus (study group) or conventional fornix-based conjunctival flap (control group). Corneal astigmatism and suture-induced discomfort were assessed by keratometry and a self-devised patient questionnaire, respectively.

RESULTS

Both groups generated a "with the rule" SIA, which was 1.77 vs 2.42 at 1 week and reduced to 1.27 vs 1.8 in the study vs control group, after removal of sutures - both scleral flap releasable and conjunctival at 1 month. Patient discomfort score revealed enhanced comfort in 37% of patients (study group) vs 17% (control group) during the early postoperative period. After 1 month of surgery, good comfort was regained in all cases.

CONCLUSION

This novel suturing technique results in reduced SIA, patient discomfort during the 1st month after trabeculectomy.