Primary chronic angle-closure glaucoma treated with compound trabeculectomy combined HEMA glaucoma shunting device implantation

Abstract

Objective Observe filtering bleb after compound trabeculectomy combined HEMA glaucoma shunting device implantation operation in primary chronic angle-closure glaucoma (PCACG) patients using ultrasound biomicroscopy(UBM). Methods This was a prospective cohort study. Sixty eyes of 60 subjects with PCACG were randomly devided into the research group (30 cases) and the control group(30 cases). The control group received compound trabeculectomy, and the research group received compound trabeculectomy combined with HEMA glaucoma shunting device implantation. The best corrected visual acuity (BCVA) and the intraocular pressure (IOP) were measured 1 day preoperation, and 3 months and 6 months postoperation. Filtering bleb morphology were observed at 3 months and 6 months postoperation using UBM. Data were analyzed using independent t test, repeated measured ANOVA, Fisher exact test. Results The BVCA (logMAR) of the control group were 0.63 ± 0.48, 0.54 ± 0.35 and 0.55 ± 0.34, while were 0.66 ± 0.56, 0.49 ± 0.25 and 0.50 ± 0.27 in the treatment group. The differences were not significant between groups and time points (P>0.05). The IOP of the control group was 19.2 ± 12.2 mmHg, 16.3 ± 4.5 mmHg and 16.8±4.6 mmHg (1 mmHg=0.133 kPa), respectively, while were 18.7±10.2 mmHg, 12.4± 4.1 mmHg and 12.9 ± 3.7 mmHg in the the treatment group. There was no significant difference between the two groups at 1 day preoperation (P>0.05) but with significant diffrences at 3 months and 6 months postoperation (t=-3.480,-3.628, P 0.05), but with significant differences in the research group (F=10.435, P 0.05). At 6 months after surgery, There was 77% type L bleb in the control group while 97% in the research group, the differences were significant between the two groups (χ2=5.192, P<0.05). Conclusion Compound trabeculectomy combined with HEMA glaucoma shunting device implantation is effective to reduce IOP, and easy to form functional filtering bleb, surgical success rate higher. Key words: Glaucoma, angle-closure; Glaucoma shunting device; Ultrasound biomicroscopy; Compound trabeculectomy