Perioperative complications of trabeculectomy with releasable sutures at tertiary eye center

Abstract

Abstract
Background: Trabeculectomy is a commonly performed surgical procedure for management of glaucoma in Ethiopia.
The purpose this study is to describe the frequency and types of surgical complications documented during and within
the first post-operative month after trabeculectomy with releasable sutures.
Methods: Retrospective chart review of 220 eyes of 211 patients who underwent trabeculectomy with scleral flap
closure by means of two releasable and one permanent sutures at tertiary center.
Results: Complications encountered were 8.2% (18 eyes) and 47.3% (104 eyes) intraoprative and postoperative
respectively. Twenty-one eyes had more than one complication. Anti-fibrotic agents (Mitomycin C and 5-Fluorouracil)
were used for 89.1% of the eyes. Conjunctival tears or holes (3.2%), bleb hemorrhage (1.8%), and scleral-flap-related
problems (1.8%) were the types of intraoperative complications. Elevated intraocular pressure (IOP) (17.7%),
hypotony (15.4%) and bleb leakage (9.6%) were the most common postoperative complications; while shallow or flat
anterior chambers (5.5%) and choroidal effusion (2.3%) were less frequent. Surgical intervention was done for five
eyes, whereas, in 90 (86.5%) eyes the complications were self-limiting or managed by suture removal.
Conclusion: This study has identified the majority of the complications encountered in trabeculectomy with scleral
flap closure with releasable sutures to be transient and self-limiting.
Recommendation: For resource limited countries like Ethiopia, trabeculectomy with temporary tighter scleral flap
closure is a cost-effective means to minimize the sight-threatening complications of procedure, and it can be practiced
by all ophthalmic surgeons managing glaucoma patients. [Ethiop. J. Health Dev. 2015;29(2):111-118]