The application of human anterior lens capsule autotransplantation in phacotrabeculectomy: a prospective, comparative and randomized clinical study

Abstract

To determine whether the autotransplantation of human anterior lens capsule (ALC) in the trabeculectomy site can aid filtration. We conducted a prospective, randomized, and masked clinical trial to evaluate the outcome of human ALC autotransplantation in phacotrabeculectomy. Fifty patients with coexisting cataract and uncontrolled glaucoma despite maximum medical therapy were enrolled in this study. In the ALC group, combined phacoemulsification, posterior chamber intraocular lens implantation, and trabeculectomy were performed in 29 eyes, the anterior lens capsule was then put under the scleral tunnel. In the mitomycin-C (MMC) group, phacoemulsification, posterior chamber intraocular lens implantation, and trabeculectomy were performed in 21 eyes, MMC was used intraoperatively. Follow-up period was 12 months. The appearance of filtering bleb, intraocular pressure, and best corrected visual acuity were evaluated. (1) There was no statistical difference between the ALC group and the MMC group in the formation of functional filtering blebs (chi(2)=0.132, P>0.05), intraocular pressure (t=0.007, P>0.05), the number of antiglaucoma medications (Z=-0.800, P>0.05), and best corrected visual acuity (chi(2)=0.055, P>0.05). (2) The anterior lens capsule could be detected in the filtering site by ultrasound biomicroscopy 1 month after surgery. Anterior lens capsule autotransplantation could get comparable outcome as MMC in phacotrabeculectomy with few complications.