Merits of conjunctival frill incision in reducing trabeculectomy-induced astigmatism and patient discomfort

Indian J Ophthalmol. 2021 Apr;69(4):882-885. doi: 10.4103/ijo.IJO_1489_20.

Abstract

Purpose: To compare results of a novel "conjunctival frill/smile incision" on surgically induced astigmatism (SIA) and patient discomfort vs conventional trabeculectomy in the initial postoperative period.

Methods: Sixty trabeculectomy cases were subjected to either conjunctival frill incision, performed 1.5-2.0 mm from the limbus (study group) or conventional fornix-based conjunctival flap (control group). Corneal astigmatism and suture-induced discomfort were assessed by keratometry and a self-devised patient questionnaire, respectively.

Results: Both groups generated a "with the rule" SIA, which was 1.77 vs 2.42 at 1 week and reduced to 1.27 vs 1.8 in the study vs control group, after removal of sutures - both scleral flap releasable and conjunctival at 1 month. Patient discomfort score revealed enhanced comfort in 37% of patients (study group) vs 17% (control group) during the early postoperative period. After 1 month of surgery, good comfort was regained in all cases.

Conclusion: This novel suturing technique results in reduced SIA, patient discomfort during the 1st month after trabeculectomy.

Keywords: Astigmatism; conjunctival frill incision; discomfort score; trabeculectomy.

MeSH terms

  • Astigmatism* / etiology
  • Astigmatism* / prevention & control
  • Astigmatism* / surgery
  • Conjunctiva / surgery
  • Humans
  • Intraocular Pressure
  • Sclera / surgery
  • Suture Techniques
  • Trabeculectomy* / adverse effects