Trabeculectomy combined with implantation of amniotic membrane or glaucoma drainpipe implants for glaucoma

Abstract

Objective To study the clinical effects and complications of the trabeculectomy combined with implantation of biologic amniotic membrane or glaucoma drainpipe implants for the treatment of primary glaucoma. Methods One hundred and fifty eyes of 125 cases with primary glaucoma were randomly divided into three groups. Patients in the amnion group (54 eyes of 46 cases) were treated with ordinary trabeculectomy combined with biologic amniotic membrane, Patients in the drainage group (52 eyes of 40 cases) were treated with trabeculectomy combined with glaucoma drainage implants, and patients in control group(44 eyes of 39 cases) were treated with ordinary trabeculectomy. Patients were followed up for one year. The post-operative intraocular pressure (IOP), filtration bleb and complications were observed. Results One week after operation, IOP of the amnion group was (13.76±0.81) mmHg(1 mmHg=0.133 kPa), IOP of the drainage group was (12.54±0.47)mmHg, IOP of the control group was (14.45±0.37)mmHg and the difference was not statistically significant(F=1.07, P=0.22). One year after operation, IOP of the amnion group was (11.81±0.74)mmHg, IOP of the drainage group was (11.75±0.25)mmHg and the difference was not statistically significant (P=0.06). IOP of the control group was (14.90±0.62)mmHg which was higher than that of the other two groups and the difference was statistically signicant compared with that of the other two groups (F=0.01, P=0.04). One week after operation, shallow anterior chamber happened in 6 eyes in the amnion group, 7 eyes in the drainage group and 5 eyes in control group. One year after operation, the percentage of functional filtration bleb was 92.6% in the amnion group, 94.2% in the drainage group and 65.9% in control group respectively. Conclusion The trabeculectomy combined with biologic amniotic membrane or glaucoma drainpipe implants can reduce the IOP safely and effectively, and inhibit filtering bleb cicatrization. Key words: Glaucoma, primary; Trabeculectomy; Amnion, biologic; Drainpipe, glaucoma