sutureless versus conventional trabeculectomy for management of primary open angle glaucoma

purpose : to assess the efficacy and safety of sutureless punch trabeculectomy as substitute for conventional scleral flap trabeculectomy. methods : in a prospective, randomized study, 44 eyes of 42 patients with primary open angle glaucoma (poag) who were candidate of trabeculectomy were included and randomly assigned into two groups sutureless punch trabeculectomy or conventional scleral flap trabeculectomy. intraoperative complications and postoperative visual acuity, iop, bleb status, and complications were evaluated for a follow-up period of 6 months. results : mean iop was 21.9±7.9 mmhg before surgery and 16.0±4.7 mmhg 6 months after surgery in sutureless group, and 22.7±10.2 preoperatively and 15.8±5.2 postoperatively in the control group. no significant difference in complication rate was noted between the two groups. the absolute success rate was 50% and 59% in study and control group, respectively (p=0.545), and qualified success rate was 86.3% and 90.9% in the study and control group, respectively (p=0.365). conclusion : it appears that sutureless scleral tunnel trabeculectomy is a safe and effective drainage procedure for treating uncomplicated poag, and can effectively substitute for conventional scleral flap trabeculectomy.   iranian journal of ophthalmology 200820(2):27-33