Laser suture lysis after mitomycin C trabeculectomy

E. N. Morinelli, P. A. Sidoti, D. K. Heuer, D. S. Minckler, G. Baerveldt, L. LaBree, P. P. Lee

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Abstract

Purpose: To evaluate the timing, efficacy, and complications of laser suture lysis (LSL) after mitomycin C trabeculectomy in patients with glaucoma at high risk for failure of filtering surgery. Methods: The authors retrospectively reviewed the charts of 62 consecutive patients who underwent a total of 66 sessions of LSL after trabeculectomy with mitomycin C. Results: The interval from surgery to LSL ranged from 2 to 65 days (mean ± standard deviation, 17.9 ± 14.9 days). The average intraocular pressure (IOP) reduction after LSL was 11.9 ± 8.9 mmHg (range, 3-40 mmHg). A longer interval to LSL was correlated with a lesser degree of pressure reduction (P = 0.0004, Wilcoxon rank-sum test). After LSL, hypotony developed in 13 (21%) patients (IOP < 6 mmHg on 2 consecutive measurements at least 24 hours apart). This resolved spontaneously after 7 to 304 days (104.1 ± 109.1 days) in 12 (92%) of the 13 patients. Life-table success rates (success defined as 6 mmHg ≤ final IOP ≤ 21 mmHg) for the hypotony and no hypotony groups were 100% and 86% (at 6 months) and 96% and 86% (at 12 months), respectively. The final visual acuity worsened in a significantly greater percentage of patients in the hypotony group (46%) compared with the no-hypotony group (18%) (P = 0.06, Fisher's exact test). Conclusions: Laser suture lysis is safe and effective in augmenting aqueous filtration after mitomycin C trabeculectomy. A longer time interval between surgery and LSL may result in both a lesser degree of IOP reduction and a lower incidence of subsequent hypotony.

Original languageEnglish
Pages (from-to)306-314
Number of pages9
JournalOphthalmology
Volume103
Issue number2
DOIs
StatePublished - 1996
Externally publishedYes

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