Raina U K, Tuli D
Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India.
Arch Ophthalmol. 1998 Oct;116(10):1288-93. doi: 10.1001/archopht.116.10.1288.
To compare the short-term and long-term efficacy of using releasable sutures vs conventional interrupted sutures for scleral flap suturing in trabeculectomy.
A prospective randomized study.
A university-affiliated referral eye hospital.
Thirty consecutive patients requiring trabeculectomy for uncontrolled primary glaucoma.
Fifteen patients underwent trabeculectomy with permanent interrupted sutures; the same number underwent trabeculectomy with releasable sutures.
Incidence of short-term shallowing of anterior chamber or hypotony and related complications, and long-term intraocular pressure control and bleb score.
The mean percentage reduction in intraocular pressure on day 1 in the group with releasable sutures was 55.2%, while only a 0.8% reduction in anterior chamber depth was noted. This compared with figures of 59.3% and 10.1%, respectively, in the group without releasable sutures. Hypotony (intraocular pressure < or =6 mm Hg) was noted in 8 (53%) of cases without releasable sutures and 3 (20%) of cases with releasable sutures. Shallow anterior chamber (central anterior chamber depth, < or =1 mm) was noted in 5 (33%) of cases without releasable sutures and 1 (7%) of cases with releasable sutures. The mean +/- SD final bleb score was 5.4 +/- 0.3 in the group with releasable sutures compared with 4.2 +/- 0.6 in the group without releasable sutures (P<.001). The mean +/- SD final intraocular pressure at the end of 12 months was 16.9 +/- 1.2 mm Hg in the group without releasable sutures and 15.0 +/- 0.9 mm Hg in the group with releasable sutures (P<.001). Final intraocular pressure was controlled (intraocular pressure < or =21 mm Hg) in all patients in the group with releasable sutures, giving a success rate of 100%, and in 12 patients in the group without releasable sutures, giving a success rate of 80%.
Use of releasable sutures is an effective way at no extra cost or instrumentation to maximize the long-term bleb score and lower intraocular pressure, and to minimize the short-term complications of trabeculectomy.
比较小梁切除术中使用可松解缝线与传统间断缝线进行巩膜瓣缝合的短期和长期疗效。
一项前瞻性随机研究。
一家大学附属医院的转诊眼科医院。
连续30例因原发性青光眼控制不佳而需要进行小梁切除术的患者。
15例患者接受了永久性间断缝线小梁切除术；相同数量的患者接受了可松解缝线小梁切除术。
前房短期变浅或低眼压及相关并发症的发生率，以及长期眼压控制和滤过泡评分。
使用可松解缝线组在第1天眼压平均降低百分比为55.2%，而前房深度仅降低0.8%。相比之下，未使用可松解缝线组的这两个数字分别为59.3%和10.1%。未使用可松解缝线的病例中有8例（53%）出现低眼压（眼压≤6mmHg），使用可松解缝线的病例中有3例（20%）出现低眼压。未使用可松解缝线的病例中有5例（33%）出现前房浅（中央前房深度≤1mm），使用可松解缝线的病例中有1例（7%）出现前房浅。使用可松解缝线组的平均±标准差最终滤过泡评分为5.4±0.3，未使用可松解缝线组为4.2±0.6（P<0.001）。12个月结束时，未使用可松解缝线组的平均±标准差最终眼压为16.9±1.2mmHg，使用可松解缝线组为15.0±0.9mmHg（P<0.001）。使用可松解缝线组的所有患者最终眼压均得到控制（眼压≤21mmHg），成功率为100%，未使用可松解缝线组有12例患者眼压得到控制，成功率为80%。
使用可松解缝线是一种无需额外成本或器械的有效方法，可使长期滤过泡评分最大化、降低眼压，并将小梁切除术的短期并发症降至最低。
