The effect of the timing of scleral flap suture release on the safety and long-term success of phacotrabeculectomy

To investigate the effect of the timing of the scleral flap suture release on the safety and long-term success of phacotrabeculectomy.Retrospective, nonrandomized chart review.We studied 173 eyes of 173 consecutive patients who underwent primary phacotrabeculectomy, with or without intraoperative mitomycin-C, and subsequent scleral flap suture release.Early suture release (3 weeks) had a lower long-term success rate than late suture release (3 weeks), with an average follow-up period of 44.8 months. Patients who used mitomycin-C had statistically later suture release than did patients without mitomycin-C. There were nine cases of hypotony, for which independent risk factors were early suture release and the use of mitomycin-C.Greater long-term success with minimal complications was achieved when scleral flap suture release was performed three weeks after phacotrabeculectomy. Suture release within three weeks after surgery was associated with an increased risk of filtration failure and a higher risk of postoperative complications.