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Trabeculectomy With or Without Anterior Chamber Maintainer and Adjustable Sutures

Vandewalle, Evelien MD, PhD*,†; Van de Veire, Sara MD, PhD; Renier, Charlotte MD§; Stalmans, Ingeborg MD, PhD*,†; Zeyen, Thierry MD, PhD*

doi: 10.1097/IJG.0b013e318269806a
Original Studies

Purpose: To assess the long-term outcomes of trabeculectomy using an anterior chamber maintainer and a combination of adjustable and releasable sutures compared with trabeculectomy using a viscoelastic and solely releasable sutures.

Methods: In a prospective, randomized, single-center study, 2 different trabeculectomy techniques were compared. One eye of each patient was randomly assigned to trabeculectomy with an anterior chamber maintainer and a combination of 2 adjustable and 2 releasable flap sutures (technique 1), whereas the other eye had trabeculectomy with viscoelastic and 2 releasable flap sutures (technique 2). The postoperative management was comparable in both groups except for the manipulation of the adjustable sutures. The main outcome measures were the postoperative intraocular pressure (IOP), the frequency of early postoperative complications and interventions, and the number of glaucoma medications.

Results: Thirty-two patients were included and had a follow-up of at least 18 months. The preoperative and postoperative IOP at 18 months was 22.1±8 and 13.3±2 mm Hg in the group using technique 1 and 22.7±7 and 13.3±3 mm Hg in the group using technique 2, respectively (mean±SD; P=0.18 for IOP reduction between both techniques). Early postoperative complications and interventions were infrequent and comparable in both techniques. The reduction in number of medications was not significantly different between the 2 groups (mean±SD from 2.4±1.0 to 0.4±0.8 in the group using technique 1 and from 2.3±1.0 to 0.2±0.5 in the group using technique 2; P=0.50).

Conclusions: There is no significant difference in IOP reduction, in frequency of postoperative complications and interventions, or in reduction of medications between the 2 techniques.

*Department of Ophthalmology, University Hospitals Leuven

Laboratory of Ophthalmology, Department of Ophthalmology Neurosciences, KU Leuven, Leuven, Belgium

Department of Ophthalmology, University Hospital Maastricht, Maastricht

§Department of Ophthalmology, Leids University Medical Centre, Leiden, The Netherlands

Disclosure: E.V. was supported with a grant from the FWO “Fonds Wetenschappelijk Onderzoek–Vlaanderen.” The remaining authors declare no conflict of interest.

Reprints: Thierry Zeyen, MD, PhD, Department of Ophthalmology, University Hospitals Leuven, Campus St Raphaël, Kapucijnenvoer 33, B-3000 Leuven, Belgium (e-mail:

Received December 19, 2011

Accepted June 12, 2012

© 2014 by Lippincott Williams & Wilkins.