Single-Stab Trabeculectomy: New Technique for Glaucoma Filtering Surgery for Minimizing Scar Induction and Bleb Failure
Narrative Responses:
Purpose
To evaluate a new technique for Single Stab Trabeculectomy (SST) working on a compromised tunnel principle
Methods
Patients requiring glaucoma filtering surgery with or without phaco were included. A trans-conjunctival single stab entry through lamellar sclera and cornea into the AC was created without dissecting conjunctiva. If combined with phaco, cataract extraction and IOL implantation were carried out at this stage. The internal lip of the tunnel thus obtained was punched with A kelly's Descemet's punch. A PI was done in select cases. Filtration was verified and conjunctiva was closed with a continuous 10-0 nylon suture.
Results
20 patients underwent either single stab trab with or without phaco. 1 case experienced a premature entry and was converted into conventional trab. Surgery was uneventful in all other cases. Post-operative period was uneventful in all cases except one patient who developed a steroid induced glaucoma that responded to withdrawl of steroids.
Conclusion
Glaucoma filtering surgery can be simpler, more effective, less fibrogenic by simple variation in established technique of trabeculectomy. Compromised tunnel gives effective filtration and good lowering of IOP. Absence of conjunctival dissection induces less scar, less failure and leaves more virgin conjunctiva. Early results are promising. Larger study is underway.