Trabeculotomo-ectomy combined with amniotic membrane grafting for the treatment of congenital glaucoma

Abstract

Objective To investigate the clinical efficacy and safety of trabeculotomo-ectomy (combined sugery of trabeculotomy and trabeculectomy) combined with amniotic membrane grafting for the treatment of primary congenital glaucoma. Methods Forty-seven eyes of 26 patients with primary congenital glaucoma were treated with the operation of trabeculotomo-ectomy combined with amniotic membrane grafting. The intraocular pressure, corneal diameter, transparency of cornea, length of sagittal axis, filter bleb, the ratio of cup to disc and complication were observed, and the therapeutic effect was analyzed. Results The preoperative intraocular pressure was (37.80±11.24) mmHg (1 mmHg=0.133 kPa), the preoperative corneal diameter was (13.31±0.61)mm, and obvious corneal edema was in 42 eyes accounting for 89.36%. The follow-up period was 12-24 months with an average of (15.03±7.34) months. The intraocular pressure after surgery was (16.41±2.91) mmHg and compared with that before surgery, the difference was statistically significant (t=10.402, P=0.000). The functional filtering blet formed in 29 eyes accounting for 61.70%. After the follow-up of three months after the operation, the eye axis reduced significantly compared with the preoperative one (t=4.081, P=0.003). The differences in corneal diameter and C/D ratio between before and after the operation were not statistically significant(t=0.931, P=0.188; t=0.431, P=0.293). The cornea of 37 eyes (88.10%, 37/42) was transparent after the surgery and the corneal edema alleviated obviously in 5 eyes (11.9%, 5/42) after the surgery. No obvious complication occurred. Conclusion Trabeculotomo-ectomy combined with amniotic membrane grafting is a safe and effective method for congenital glaucoma. Key words: Glaucoma, congenital, primary; Trabeculotomo-ectomy (trabeculotomy combined with trabeculectomy); Grafting, amniotic membrane