Posters

Conjunctival frill/SMILE incision trabeculectomy vs conventional flap surgery

Poster Details

First Author: D.Kishore INDIA

Co Author(s):    K. Singh   M. Bhattacharyya   S. Kumar   N. Gotmare   A. Joon   H. Agarwal     

Abstract Details

Purpose:

To evaluate bleb morphology after novel “Conjunctival frill/Smile” incision trabeculectomy vs conventional flap surgery using anterior segment OCT

Setting:

Prospective randomised control study conducted in the Glaucoma clinic of Guru Nanak Eye Centre, Maulana Azad medical college, New Delhi, India

Methods:

Sixty patients scheduled for trabeculectomy were randomised to either conjunctival frill incision (Study group), made 1.5 -2.0 mm from limbus sutured with running, horizontal mattress suturing vs fornix based flap (Control group). Bleb evolution was studied over 6-months period by IBAGS & AS-OCT

Results:

Bleb morphology was similar regarding extent(E),vascularity(V)with moderate bleb height (H2) being more frequent in study group(SG).Bleb maturation in control group resulted in a slight flattening(statistically significant decrease in bleb height (p<0.04, friedman test)),whereas for frill incision(SG)moderate bleb height was maintained at 6months.Quantitative bleb assessment by AS-OCT documented bleb-wall thickness as 115-127µ and 114-121µ in study vs control,bleb-height reduced from 242 to 230µ after attaining bleb maturity in control group,with more number of microcysts(15 vs 13 out of 30) in SG.Our study documented positive correlation between bleb wall thickness,internal reflectivity,microcysts and IOP control;and negative correlation between bleb height and IOP

Conclusions:

Conjunctival frill incision generates a functional healthy bleb with better wall thickness, increased internal reflectivity at an intermediate follow up of 6 months.

Financial Disclosure:

None