Abstract：
OBJECTIVE: Comparing the effect of standard trabeculectomy with direct sutures versus trabeculectomy with compression and everting sutures.
METHODS: Mono-centric randomized prospective comparative study on 38 glaucomatous eyes undergoing trabeculectomy: 19 with standard fixed sutures (group A) and 19 withremovable regulating sutures (group B). Preoperatively and at day-7, 1-month, 2-months, 3-months and 6-months after surgery, we recorded best-corrected visual acuity (BCVA), intraocular pressure (IOP) and possible complications. Complete, partial success and failure rates were recorded at the end of the study.
RESULTS: In group B, we pulled everting sutures with the \"horse bridle\" technique at the 14th day, and successively removed all sutures between the 14th-30th post-operative day. At month-1, we recorded a significant IOP reduction in both groups (mean reduction of 11.5 mmHg for group A and of 14.4 mmHg for Group B, p = 0.001 and p < 0.0001, respectively). Furthermore, group B showed a significantly lower IOP than group A (-4.2 mmHg, 95% confidence interval [CI] -7.0 to -0.5 mmHg for group B, p = 0.01). At 2, 3 and 6-months, no significant IOP differences were reported between the two groups (all p > 0.05), but failure rate was higher for group A (21%) than for group B (11%). No differences in visual outcomes at any timepoints were noted.
CONCLUSIONS: Trabeculectomy with removable regulating sutures showed a good safety profile, comparable to standard trabeculectomy. Moreover, we reported a lower IOP one month postoperatively, suggesting this technique may optimize early management of trabeculectomy.
METHODS: Mono-centric randomized prospective comparative study on 38 glaucomatous eyes undergoing trabeculectomy: 19 with standard fixed sutures (group A) and 19 withremovable regulating sutures (group B). Preoperatively and at day-7, 1-month, 2-months, 3-months and 6-months after surgery, we recorded best-corrected visual acuity (BCVA), intraocular pressure (IOP) and possible complications. Complete, partial success and failure rates were recorded at the end of the study.
RESULTS: In group B, we pulled everting sutures with the \"horse bridle\" technique at the 14th day, and successively removed all sutures between the 14th-30th post-operative day. At month-1, we recorded a significant IOP reduction in both groups (mean reduction of 11.5 mmHg for group A and of 14.4 mmHg for Group B, p = 0.001 and p < 0.0001, respectively). Furthermore, group B showed a significantly lower IOP than group A (-4.2 mmHg, 95% confidence interval [CI] -7.0 to -0.5 mmHg for group B, p = 0.01). At 2, 3 and 6-months, no significant IOP differences were reported between the two groups (all p > 0.05), but failure rate was higher for group A (21%) than for group B (11%). No differences in visual outcomes at any timepoints were noted.
CONCLUSIONS: Trabeculectomy with removable regulating sutures showed a good safety profile, comparable to standard trabeculectomy. Moreover, we reported a lower IOP one month postoperatively, suggesting this technique may optimize early management of trabeculectomy.
摘要：
目的：比较标准小梁切除术与直接缝合与压缩和外翻缝合的效果。
方法：对38只青光眼进行小梁切除术的单中心随机前瞻性比较研究：19只采用标准固定缝线（A组）和19只采用可移除调节缝线（B组）。术前和第7天，1个月，2个月,手术后3个月和6个月，我们记录了最佳矫正视力（BCVA），眼内压（IOP）和可能的并发症。完成,在研究结束时记录部分成功率和失败率.
结果：在B组中，我们在第14天用“马绳”技术拉了外翻缝线，并在术后14日至30日之间连续移除所有缝线。在第1个月，我们记录到两组的IOP均显着降低（A组平均降低11.5mmHg，B组平均降低14.4mmHg，分别为p=0.001和p<0.0001)。此外，B组的眼压明显低于A组（-4.2mmHg，B组的95%置信区间[CI]-7.0至-0.5mmHg，p=0.01)。在2、3和6个月时，两组间无明显眼压差异(均P>0.05),但A组的失败率(21%)高于B组(11%)。没有注意到在任何时间点的视觉结果的差异。
结论：小梁切除术结合可移除调节缝线显示出良好的安全性，与标准小梁切除术相当。此外，我们报告术后1个月眼压较低,提示该技术可以优化小梁切除术的早期管理。
方法：对38只青光眼进行小梁切除术的单中心随机前瞻性比较研究：19只采用标准固定缝线（A组）和19只采用可移除调节缝线（B组）。术前和第7天，1个月，2个月,手术后3个月和6个月，我们记录了最佳矫正视力（BCVA），眼内压（IOP）和可能的并发症。完成,在研究结束时记录部分成功率和失败率.
结果：在B组中，我们在第14天用“马绳”技术拉了外翻缝线，并在术后14日至30日之间连续移除所有缝线。在第1个月，我们记录到两组的IOP均显着降低（A组平均降低11.5mmHg，B组平均降低14.4mmHg，分别为p=0.001和p<0.0001)。此外，B组的眼压明显低于A组（-4.2mmHg，B组的95%置信区间[CI]-7.0至-0.5mmHg，p=0.01)。在2、3和6个月时，两组间无明显眼压差异(均P>0.05),但A组的失败率(21%)高于B组(11%)。没有注意到在任何时间点的视觉结果的差异。
结论：小梁切除术结合可移除调节缝线显示出良好的安全性，与标准小梁切除术相当。此外，我们报告术后1个月眼压较低,提示该技术可以优化小梁切除术的早期管理。
