Tenon's traction sutures: an aid for trabeculectomy and aqueous drainage device implantation.

PURPOSE: To describe a surgical technique to improve visualization and surgical access for trabeculectomy and implantation of aqueous drainage devices.

MATERIALS AND METHODS: After the corneal traction suture (6-0 polygalactin; S-29 needle) is placed, a second suture is passed through Tenon's capsule alone, either at the anterior edge of a limbus-based conjunctival flap for trabeculectomy or at the incisional edge of a fornix-based conjunctival flap for drainage implant surgery.

RESULTS: The incision for limbus-based peritomies must be posterior enough to take advantage of the posterior thickening of Tenon's capsule when placing the traction suture. The use of traction sutures enhances visualization and limbal surgical access for trabeculectomy. They also enhance posterior ocular surface visualization and aid placement of scleral fixation sutures for securing the explants of aqueous drainage devices.

CONCLUSIONS: Tenon's traction sutures are an aid to visualization and to surgical access during glaucoma filtering surgery.