Laser Suture Lysis and Releasable Sutures

Since first being described by Cairns in 1968, trabeculectomy, with guarded filtration, has become the preferred surgical method of reducing intraocular pressure.1 The goal of trabeculectomy is to create a balance between aqueous humor inside the eye and the filtering conjunctival bleb. To establish this balance, a scleral flap must be created that is loose enough to allow outflow, but tight enough to prevent postoperative hypotony.2^,3 A number of adverse events may occur with overfiltration from loose sutures, including shallow chambers, choroidals, suprachoroidal hemorrhages, maculopathy, and progressive cataract formation.2^–8 Tight closure of the flap can avoid these complications but at the peril of achieving the desired intraocular pressure. To manage these dueling forces, laser suture lysis and the use of releasable suture are commonly employed.