Please use this identifier to cite or link to this item: https://doi.org/10.1136/bjophthalmol-2011-300228
Title: Do shapes and dimensions of scleral flap and sclerostomy influence aqueous outflow in trabeculectomy? A finite element simulation approach
Authors: Tse, K.M.
Lee, H.P. 
Shabana, N.
Loon, S.-C.
Watson, P.G.
Thean, S.Y.L.H.
Issue Date: Mar-2012
Source: Tse, K.M., Lee, H.P., Shabana, N., Loon, S.-C., Watson, P.G., Thean, S.Y.L.H. (2012-03). Do shapes and dimensions of scleral flap and sclerostomy influence aqueous outflow in trabeculectomy? A finite element simulation approach. British Journal of Ophthalmology 96 (3) : 432-437. ScholarBank@NUS Repository. https://doi.org/10.1136/bjophthalmol-2011-300228
Abstract: Background/aim: This study aimed to provide an objective assessment of the effects on the aqueous outflow rate of various geometries of the scleral flap and sclerostomy created in trabeculectomy. Method: Computer-based models and simulations of this surgical procedure were used to investigate the relative effects of various shapes and dimensions of scleral flap and sclerostomy on the aqueous outflow. Result: In these computer simulations, increasing scleral flap size was found to be associated with an increase of 48.55% in aqueous egress. In addition, a square scleral flap increased the aqueous drainage by 36.26% compared with a triangular flap of equivalent flap area. Surprisingly, our simulation results showed that a smaller semicircular sclerostomy improved aqueous drainage by up to 33.00%, while a semicircular sclerostomy, compared with a circular sclerostomy, led to a further 6.16% increase in aqueous outflow. Decreasing flap thickness beyond half-thickness caused an additional increase in aqueous outflow. However, clinically the flap should not be thinner than half the thickness of the sclera as this may result in hypotony. Conclusion: These simulations indicate that the optimal flow rate through operation site will be achieved in trabeculectomy using a square scleral flap with a large flap-to-sclerostomy ratio.
Source Title: British Journal of Ophthalmology
URI: http://scholarbank.nus.edu.sg/handle/10635/59983
ISSN: 00071161
DOI: 10.1136/bjophthalmol-2011-300228
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