Merits of conjunctival frill incision in reducing trabeculectomy-induced astigmatism and patient discomfort

PURPOSE: To compare results of a novel “conjunctival frill/smile incision” on surgically induced astigmatism (SIA) and patient discomfort vs conventional trabeculectomy in the initial postoperative period. METHODS: Sixty trabeculectomy cases were subjected to either conjunctival frill incision, performed 1.5–2.0 mm from the limbus (study group) or conventional fornix-based conjunctival flap (control group). Corneal astigmatism and suture-induced discomfort were assessed by keratometry and a self-devised patient questionnaire, respectively. RESULTS: Both groups generated a “with the rule” SIA, which was 1.77 vs 2.42 at 1 week and reduced to 1.27 vs 1.8 in the study vs control group, after removal of sutures – both scleral flap releasable and conjunctival at 1 month. Patient discomfort score revealed enhanced comfort in 37% of patients (study group) vs 17% (control group) during the early postoperative period. After 1 month of surgery, good comfort was regained in all cases. CONCLUSION: This novel suturing technique results in reduced SIA, patient discomfort during the 1(st) month after trabeculectomy.