External Trabeculectomy with T-Flux Implant

Abstract

Purpose

To evaluate the efficacy and safety of T-Flux implant in nonpenetrating glaucoma surgery.

Methods

This clinical interventional case series study included 35 eyes of 35 patients with medically uncontrolled primary open angle glaucoma. External trabeculectomy with T-Flux (ETTF) is a technique of nonpenetrating glaucoma surgery, in which after removing deep scleral tissue and un-roofing the canal of Schlemn (CS) the external trabecular tissue is peeled off to enhance the aqueous drainage without opening the anterior chamber. A non-absorbable T-Flux implant (IOL TECH Laboratories, France) was sutured in deep intrascleral space to keep it patent. Snellen's best-corrected visual acuity, slit lamp biomicroscopy, intraocular pressure (IOP), gonioscopy, funduscopy, and optic disc assessment were performed preoperatively and postoperatively at 1 day, 1 week, and 1, 3, 6, and 12 months. Visual field testing was performed preoperatively and at 6 and 12 months postoperatively.

Results

For three eyes, surgery was converted to standard trabeculectomy owing to the perforation of trabeculo-Descemet's membrane and iris prolapse and excluded from the study. The results of the remaining 32 eyes were included in the study. Preoperative IOP (mean ± SD) of 32.88 ± 5.7 mmHg decreased to 15.44 ± 1.6 mmHg after 12 months. Ten eyes (28.6%) had microhyphema that resolved spontaneously; 3 eyes (8.6%) had microperforation without iris prolapse so ETTF was proceeded routinely. The preoperative number of antiglaucoma medications per patient reduced from (mean ± SD) 2.74 ± 0.61 to 0.11 ± 0.32 postoperatively at 12 months. Visual acuity and visual fields remained stable.

Conclusions

ETTF appears to provide significant control of IOP and have low incidence of complications.