Subretinal suture misdirection during 360 degrees suture trabeculotomy.

Abstract

PURPOSE: To report a new complication of 360 degrees suture trabeculotomy attributable to subretinal suture misdirection. DESIGN: Observational case report. METHODS: Retrospective chart review. RESULTS: A 5-month-old female with bilateral congenital glaucoma underwent uncomplicated 360 degrees suture trabeculotomy in the right eye. In the left eye, a scleral flap was created and dissection to Schlemm's canal was achieved. A 6-0 Prolene suture was passed into Schlemm's canal long enough for 360 degrees of treatment, did not come out the opening, and was retracted. The procedure was completed with a trabeculotome. One month later, an unusual white tract was noted subretinally in the left eye. There was no overlying retinal break or detachment. The tract presumably was caused by the misdirected Prolene suture exiting Schlemm's canal prematurely and being directed posteriorly. CONCLUSIONS: Suture misdirection subretinally during cannulation of Schlemm's canal should be considered a possible complication of 360 degrees suture trabeculotomy.