What to Choose for Trabeculectomy, 10/0 Nylon Monofilament or 8/0 Virgin Silk?

Doi: 10.36351/pjo.v37i3.1230

Abstract

Purpose:  To compare between 10/0 nylon monofilament and 8/0 virgin silk for conventional trabeculectomy in terms of rate of complications and bleb morphology.

Study Design:  Quasi experimental study.

Place and Duration of Study:  Abbasi Shaheed Hospital, Karachi, from January 2017 to December 2018.

Methods:  Thirty six patients who underwent conventional trabeculectomy with 6 months follow-up were included. Trabeculectomy for congenital, neovascular, traumatic glaucoma, revised surgery and laser trabeculoplasty were excluded. In group A, scleral flap and conjunctiva were closed with 8/0 virgin silk and in group B, 10/0 nylon monofilament was used. Main outcome measure was complications.

Results:  Group A had 13 (36%) and group B had 23 (63.9%) patients. Mean age was 55.5 ± 10.69. Pre-operative Intraocular pressure (IOP) was 33.4 ± 6.3 and 33.5 ± 12 mm Hg in group A & B respectively. Postoperatively at 3^rd month IOP was 16.8 in group A and 15.0 in group B (p = 0.24).Shallow Anterior chamber was in 53% (n = 7) patients with 8/0 silk and 13% (n = 3) patients with 10/0 nylon with p value of < 0.05. Seidel test was positive in 38% (n = 5) patients in group A (p < 0.01). Re-suturing was done in 38% (n = 5) patients in group A with a p-value (p < 0.01).

Conclusion:  Shallow anterior chamber, wound leak with positive seidel test and additional intervention for re-suturing were more common in group A than group B. Diffuse blebs were frequently seen with both suture materials. Suture material does not affect final intra ocular pressure and success of trabeculectomy.

Key Words:  Bleb, Trabeculectomy, 10/0 Nylon, 8/0 silk.