Compound trabeculectomy with sluice-like pool under scleral flap for treatment of refractory glaucoma

Abstract

Objective To investigate the clinical efffect of compound trabeculectomy with sluicelike pool under scleral flap combined with amniotic membrane transplantation,mitomycin-C and adjustable sutures in treating refractory glaucoma.Methods 102 eyes of 95 patients were randomly assigned to receive trabeculectomy with or without sluice pool.The observer group(52 eyes of 48 patients) underwent trabeculectomy with sluice-like pool under scleral flap combined with amniotic membrane transplantation and mitomycin-C application.The control group (50 eyes of 47 patients) underwent conventional trabeculectomy.The follow-up were from 4 months to 15 months.Results No significant differences in visual acuity were found between the two groups (x2 =1.14,P =0.75).The postoperative IOPs were significantly lower than the preoperative IOPs in both groups,while the lOPs between the two groups were not significantly different two weeks after the surgery ( t =1.86,P =0.08).The average postoperative IOP at the 6 months was (14.75 ±3.87) mmHg in the observer group and (19.25 ±7.14)mmHg in the control group; The success rates were 86.54％ and 64.00％ in the two groups respectively (x2 =3.85,P ＜ 0.05 ).The percentage of functional filtering blebs in the observer group was 83.0％,significantly higher than that of the control group (61.4％) (x2 =3.85,P ＜ 0.05).The incidence rate of shallow anterior chamber in the observer group was higher than that in the control group,but all the cases had recovered by the end of 1 week after operation.Conclusion The Combined trabeculectomy with shuice-like pool has the advantages of preventing postoperative scar formation and achieving better control of postoperative IOP over the conventional trabeculectomy in treating refractory glaucoma. Key words: Glaucoma, refractory; Trabeculectomy, compound; Sluice pool under scleral flap ; Amniotic membrane; Mitomycin C