|Year : 1979 | Volume
| Issue : 4 | Page : 157
The new tailor-stitch operation for glaucoma
Keiki R Mehta, SN Sathe, SD Keryaker
Eye Clinic, Sea Side, 147, Colaba Road, Mumbai-400005, India
Keiki R Mehta
Eye Clinic, Sea Side, 147, Colaba Road, Mumbai-400005
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mehta KR, Sathe S N, Keryaker S D. The new tailor-stitch operation for glaucoma. Indian J Ophthalmol 1979;27:157
The types of surgery attempted for glaucoma are legion. Most of the types of surgery done for glaucoma though, fall under the group of "Drainage" operations.
The types of surgery we envisaged utilises a ( nylon running double loop tailor stitch. The mode of function is subconjunctival drainage.
| Materials and Methods|| |
A total of 15 cases have been operated by the new nylon stitch for glaucoma. The maximum follow-up is four months.
(a) Local anaesthesia.
(b) Limbal based-broad conjunctival flap.
(c) Corneal entry at 12 O'clock position 2mmfrom the limbus 4.0 nylon leaded knife needle inserted via the corneal opening.
(d) Penetration at sclera utilising the rubber bung of a disposable steriware 2cc syringe piston as counterpressure.
(e) Stitches introduced as per pattern using a modified sewing machine needle with an eye to permit a 4-0 nylon to be threaded. The locking suture is located on the outside of the sclera and is tied at the temporal end.
(f) Conjunctiva sutured up.
(g) Subconjunctival garamycin and decadron.
Surgical Variation for pressure
On an average, we do 4 perforations with sutures if the tension is below 30, and 5 if between 30 to 50.
Above 50 we put 6. We have done upto 8 but no advantage occured beyond an average of 4 perforations. All perforations are placed 3mm apart.
We prefer to keep the pupil contracted for the first few days to prevent any adhesion formation. Diamox
is not utilised. Steroid props arc used for the first month as a routine.
The eye is usually quiet with a flat diffuse bleb. Patients are taught to rub the retainer band through the Iids daily.
| Results|| |
We have operated 15 cases of glaucoma, 4 of which were absolute. Surprisingly we have attained control in all except one.
This case had a previously failed Scheie operation and had a scarred adherent conjunctiva which did not permit bleb formation.
Routine chronic simple glaucoma did well in all cases. Applanation pressure of below 18mm of Hg was achieved with no supplimentary medicine.
| Conclusion|| |
There is no need for sophisticated instrumentation and with its excellent results leads us to believe that it will stand the test of time and replace other antiglaucomatous procedures as a standard technique for the control of open angle glaucoma.