OPTIMIZING GLAUCOMA MANAGEMENT: A COMPARATIVE STUDY OF TRABECULECTOMY OUTCOMES WITH FORNIX-BASED AND LIMBAL-BASED CONJUNCTIVAL FLAPS

Background: Glaucoma, characterized by chronic optic neuropathy, visual field loss, and elevated intraocular pressure (IOP), necessitates effective management. Trabeculectomy, a pivotal surgical intervention, involves creating a new drainage pathway. This study explores the comparative analysis between fornix-based and limbal-based conjunctival flaps in trabeculectomy, aiming to provide insights into success rates and complications. Conjunctival Flaps: Fornix-based or Limbal-based: Trabeculectomy's success is intricately linked to conjunctival flap choice, either fornix-based or limbal-based. The study evaluates each approach's advantages, considerations, and objectives to guide clinicians in optimizing surgical interventions for glaucoma patients. Materials and Methods: A prospective, non-randomized study conducted from September 2018 to August 2019 at MIMS, Vizianagaram, included 50 cases of primary glaucoma divided into Group A (limbal-based) and Group B (fornix-based). Inclusion and exclusion criteria were defined, and ethical considerations were adhered to. Results: The study provides demographic and IOP data, indicating comparable reductions in both groups over the follow-up period. Intraoperative and post-operative complications, visual acuity changes, and bleb evaluations are presented. Group A exhibited higher complications during the post-operative period. Conclusion: Fornix-based conjunctival flaps in trabeculectomy demonstrated advantages over limbal-based flaps in ease of fashioning, enhanced exposure, good bleb morphology, sustained IOP reduction, and decreased complications. The study contributes practical insights for ophthalmic surgeons in optimizing patient outcomes and suggests avenues for further research in trabeculectomy procedures.