Suitability for day surgery of trabeculectomy and phacotrabeculectomy using 10-0 polyglactin suture

Objective: To evaluate the suitability of trabeculectomy or phacotrabeculectomy as a day case procedure with the objective of keeping the post-operative intraocular pressure (IOP) under control, both short-term and long-term, and post-operative complications at a low level. Method: A total of 27 eyes undergoing trabeculectomy with or without phacoemulsification for either primary open angle glaucoma or chronic angle closure glaucoma were chosen. All of them had surgery as day cases under sub-tenon injection. IOP check was done at baseline, day 1, month 1, month 6 and year 1 on 27 eyes. Post-operative complications directly related to aqueous drainage were noted at day 1. Result: Mean, mode and range of IOP at each level were analysed. Mean pre-operative IOP was 23.34 mmHg. Post-operative IOP was lowest on day 1 (mean 10.03 mm) which stabilised to mean IOP of 16.3 mmHg at year 1. At 1 year the success rate (IOP less than 21 mmHg) was 92.3% without any glaucoma medication; however, if IOP control with medication (less in number than before surgery) is taken into account the success rate was 96%. Post-operative complications were few and transient. Conclusion: Graded control of post-operative IOP was possible using 10-0 polyglactin suture. IOP on day 1 was not very low due to adequate suture tension and at the same time good control of IOP longterm (1 year in this study) was possible due to gradual release of suture tension by slow absorption. This is ideally suited for day surgery.