What are pearls for flap suturing during trabeculectomy?

Updated: May 18, 2020
  • Author: Maria Hannah Pia Uyloan de Guzman, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Flap suturing

Some surgeons prefer to pre-place the first 1 or 2 flap sutures before AC entry. This allows rapid closure of the scleral flap and lowers the risk of transient severe hypotony, which is thought to lead to suprachoroidal hemorrhage and the phenomenon of loss of central vision postoperatively (ie, wipe out or snuff out) in eyes with advanced glaucomatous visual field loss. [28, 29] However, pre-placing sutures can be difficult due to the need for careful arrangement of the loose suture ends and the high likelihood of snagging or snarling the suture.

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