Sutureless versus Conventional Trabeculectomy for Management of Primary Open Angle Glaucoma

To assess the efficacy and safety of sutureless punch trabeculectomy as substitute for conventional scleral flap trabeculectomy. 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. 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). 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.