By Steven R. Shields, MD; Rocio Bentivegna, MD; Matthew Starr, MS
    AAO 2014

    Fornix-based conjunctival incisions for limbal filtration in glaucoma surgeries have several advantages over limbus-based incisions, including better exposure of the limbus, less tissue dissection, reduced surgical time and faster visual recovery. The major disadvantage is a higher incidence of leaks from the conjuctival closure compared with limbus-based closures. Here, we present an instructional video of a "couching" technique that has decreased the problems with fornix-based conjunctival leaks in our practice. The closure consists of a single continuous suture secured with a single knot at one edge of the incision. We also present our review of cases before and after the adoption of this new closure to demonstrate the reduction in leaks using "couched compression closure.