Effect of non-penetrating trabecular surgery with amniotic membrane implant on patients with juvenile glaucoma

Abstract

To evaluate the effect of non-penetrating trabecular surgery (NPTS) with amniotic membrane implant in patients with juvenile glaucoma. NPTS with amniotic membrane implant was performed on 32 eyes of 26 patients with juvenile glaucoma aged between 12 approximately 28 years. Intraocular pressure (IOP) was measured pre- and post-operatively by CT-60 non-contact tonometer, intraocular irritations and the bleb appearances were recorded, and the anterior chamber angle of post-operation was observed by gonioscopy. Follow-up was (8.3 +/- 4.2) months after surgery. IOP of post-operation was significantly decreased (15.7 +/- 3.7) mm Hg (1 mm Hg = 0.133 kPa; t = 4.82, P < 0.01) compared with that of pre-operation (28.6 +/- 7.3) mm Hg. The mean number of drug usage was significantly reduced to 0.8 (t = 128, P < 0.01) after surgery when compared with 3.2 before surgery. On the last visit, the IOP was <or= 21 mm Hg in 30 eyes (93.8%), among them, there were 18 eyes (56.3%) without anti-glaucoma medication and 12 eyes (37.5%) with anti-glaucoma compounds. There was a small amount of hyphema that was absorbed in 3 approximately 5 days in 6 eyes. The gonioscopy showed that the remnant trabecular meshwork and Descemet membrane were thinner at the surgical site, and microperforation occurred in the trabecular meshwork in 5 eyes. The complications such as flat chamber, inflammation and choroidal detachment were not observed. There was no significant difference in visual acuity between pre- and post-operation. NPTS with amniotic membrane implant effectively controls elevated IOP in patients with juvenile glaucoma and reduced the number of anti-glaucoma drug usage without significant post-operative complications. NPTS with amniotic membrane implant is an effective and new method for the treatment of patients with juvenile glaucoma.