The effect of Stab incision glaucoma filtering surgery on Intraocular pressure in primary angle closure glaucoma

Abstract

Abstract Objective: The current study aims to evaluate the stab incision trabeculectomy technique on the intraocular pressure in primary angle closure glaucoma patients. Subjects and methods: this study included 24 cases with an indication for glaucoma surgery with the stab incision technique; superior subconjunctival injection of 0.1 ml of 0.02% mitomycin C (MMC) a stab incision was done through the conjunctiva; a scleral tunnel was created just 2.5 mm posterior to the limbus toward the cornea by a 2.8 mm keratome, A Kelly's punch was introduced through the tunnel into the A.C. the posterior lip of the corneal section was punched backwards till the limbus, additional punches were done to settle the tunnel then the iris was grasped and excised by curved Vannas scissors performing a peripheral iridotomy. IOP was measured by the Goldmann applanation tonometer preoperatively and in the follow-up on the first day, the seventh day, the first month, the third month and the sixth month. Results: The preoperative mean intraocular pressure was 28 mmHg (SD 5.1). Mean Postoperative IOP on the first day, third day, first week, first month, third month, and the sixth month was (9.5 mmHg (SD 5.1), 10.9 mmHg (SD 3.1),13.2 mmHg (SD 3.7), 15.5 mmHg (SD 5.5),15 mmHg (SD 4) and 14.3 mmHg (SD 2.4) respectively). In postoperative titrations among the studied cases, 8 (33.3%) cases required needling, which was statistically significant. (P value 0.025 %). 11 (45.8 %) cases required massage, which was statistically significant. (P value 0.000 %). 4 (16.7 %) cases required surgery, which was statistically significant. (P value 0.004 %). 6 (25 %) cases required anti-glaucoma drops, which was statistically significant. (P value 0.021 %). Hyphemia occurred in 1 case (4.2 %) of cases. Conclusion: Stab incision technique was a safe and quick alternative to conventional trabeculectomy. IOP control with fewer complications was observed during the first six months of follow‑up; mean Intraocular pressure was ~14 mmHg.