Comparison of a Modified Trabeculectomy Technique With Standard Trabeculectomy in Respect to Effectivity and Complication Rates.

PURPOSE: To compare the results of modified trabeculectomy with a central scleral gutter under the flap and releasable suture with standard trabeculectomy for open angle glaucoma cases.

DESIGN

Retrospective.

METHOD: This retrospective comparative case series evaluated the outcomes of modified trabeculectomy in 32 eyes and standard trabeculectomy in 44 eyes with primary open-angle glaucoma or pseudoexfoliative glaucoma. Success was defined as achieving an intraocular pressure (IOP) ≤ 21 mmHg with or without the use of IOP-lowering eyedrops and no need for additional glaucoma surgery.

RESULTS

There were 20 men (62.5%) and 12 women (37.5%), with a mean age of 61.9 ± 10.5 years in the modified trabeculectomy group and 27 men (61.4%) and 17 women (38.6%), with a mean age of 62.3 ± 9.8 years in the standard trabeculectomy group. Modified trabeculectomy group had a preoperative IOP of 26.9 ± 8.1 mmHg and a postoperative IOP of 15.3 ± 4.1 mmHg (p < 0.001), with an average follow-up period of 38.5 ± 17.2 months. Patients undergoing standard trabeculectomy had a preoperative IOP of 26.7 ± 8.7 mmHg and a postoperative IOP of 14.5 ± 4.6 mmHg (p < 0.001), with an average follow-up period of 42.4 ± 9.4 months. The success rate was 97.7% in the standard trabeculectomy group and 96.8% in the modified trabeculectomy group. In the modified trabeculectomy group, 30 (93.7%) had no complications, compared to 33 (75%) in the standard trabeculectomy group (p = 0.03). Anterior chamber shallowing was observed in 2 eyes (6.3%) in the modified trabeculectomy group, whereas the standard trabeculectomy group exhibited a broader complication profile, including anterior chamber shallowing in 4 eyes (9.0%), needling revision in 3 eyes (6.8%), hyphema in 2 eyes (4.5%), and choroidal detachment in 2 eyes (4.5%).

CONCLUSION

The modified trabeculectomy surgery lowers IOP effectively with a lower incidence of postoperative surgical complications.