Purpose: To investigate the short-term outcomes of tenons retractor-assisted trabeculectomy in patients with secondary glaucoma.
Subjects and methods: We retrospectively investigated 12 eyes in 11 consecutive patients who underwent tenons retractor-assisted trabeculectomy with mitomycin for secondary glaucoma at Kobe University Hospital between April 2016 and May 2017. This novel procedure possesses the following features: (1) a tenons retractor is used to secure sufficient space between the sclera and Tenon's capsule and extensively place sponges soaked with mitomycin C into the posterior space of the sclera,(2) no sutures are placed in the posterior scleral flap, and (3) a 3×6 mm blocking suture is placed close to the conjunctiva limbi. The treatment effects were evaluated based on pre- and postoperative changes in intraocular pressure (IOP) and glaucoma ophthalmic solution scores and the details of postoperative management.
Results: The causes of secondary glaucoma were uveitic glaucoma (6 eyes), neovascular glaucoma (4 eyes), and exfoliation glaucoma (2 eyes). Mean IOP significantly decreased from 34.8±13.8 mmHg preoperatively to 18.1±4.0 mmHg at 12 months postoperatively (p<0.001). Mean eye drop scores also decreased significantly from 4.3±1.2 preoperatively to 1.1±1.5 at 12 months postoperatively (p<0.001). Excluding one case with neovascular glaucoma that required bleb revision for postoperative subconjunctival scarring, no cases required postoperative management (including laser suture lysis and conjunctival sutures).
Conclusion: The short-term outcomes suggest that tenons retractor-assisted trabeculectomy appears to be a promising procedure for secondary glaucoma.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 123: 121-127, 2019.