comparison of trabeculectomy with and without releasable suture

purpose: to compare the short and long-term efficacy and complications of releasable suture vs conventional interrupted suture for scleral flap in trabeculectomy. methods: in a prospective randomized clinical trial, 42 eyes of 42 consecutive patients requiring trabeculectomy for uncontrolled primary glaucoma underwent conventional trabeculectomy (group a) and trabeculectomy with releasable sutures (group b); 21 eyes of 21 patients for each group. short-term hypotony related complications and long-term intraocular pressure were measured and compared. results: the mean follow up was 11.7 ± 6.5 months in group a and 9.4 ± 6.4 months in group b. the mean ± sd final intraocular pressure at the end of follow up period was 13.95 ± 4 mmhg in group a and 14.57 ± 3 mmhg in group b (p= 0.58). mean reduction in intraocular pressure at the end of follow up was 54.5% in group a and 56% in group b. final intraocular pressure was controlled (iop £ 20mmhg) without medications in 15 patients in group a giving a success rate of 71.4% and in 14 patients in group b giving a success rate of 66.7%. flat anterior chamber (grade iii) was observed in 2 eyes in group a but in no eyes with releasable suture. at the end of follow up, the two groups were similar regarding intraocular pressure and need for ocular hypotensive medication. conclusion:  releasable scleral flap sutures reduce the incidence of hypotony and related complication without any effects on long-term control of intraocular pressure and is an effective way with no extra cost or instrument.