Abstract
Purpose :
The purpose of this study is to evaluate clinical outcomes of trabeculectomy with amniotic membrane transplantation (AMT) and mitomycin C in patients of primary open-angle glaucoma (POAG) and normal-tension glaucoma (NTG).
Methods :
We retrospectively reviewed the medical data of the patients with POAG and NTG who had received trabeculectomy with AMT and followed up at least 6 months. Three levels of success were defined by these criteria with no medication: (A) IOP ≤18 mmHg and IOP reduction of 20%; (B) IOP ≤15 mmHg and IOP reduction of 25%; and (C) IOP ≤12 and IOP reduction of 30%. Kaplan-Meier survival analyses were used to assess outcomes. Cox proportional hazard regression analysis was used to determine prognostic factors for failure.
Results :
This study included 8 patients of NTG (9 eyes), 38 patients of POAG (43 eyes). The preoperative intraocular pressure and pattern standard deviation of the two groups showed statistically significant differences (P < 0.001, P = 0.001). Mean IOP (±standard deviation) decreased from 17.78 mmHg (±2.11 mmHg) before surgery to 11.22 mmHg (±4.27 mmHg) after surgery in NTG group and from 32.76 mmHg (±8.65 mmHg) to 11.72 mmHg (±4.48 mmHg) in POAG group at final visit (P = 0.01, P < 0.001). The success rates of NTG/POAG group were 88.9%/95.0%, 88.9%/90.4%, and 88.9%/88.4% at 1 year for criteria A, B, and C, respectively (P = 0.939, P = 0.733, P = 0.509).
Conclusions :
Trabeculectomy with AMT and MMC effectively reduces IOP in POAG and NTG. The success rate of 1 year in this study is similar to previous reports. Complications such as blebitis or endophthalmitis, avascular cystic bleb, bleb leakage did not occur during follow-up period in both groups. According to our results, the implanted amniotic membrane could be act as part of the bleb wall, which not only affects the constant flow of aqueous humor through the sclera flap due to the anti-inflammatory, antifibrotic, and antiangiogenic effects, but also relieves the pressure on the bleb wall, which is considered to contribute to prevent development of avascular cystic bleb with risk of bleb related infection..
This is a 2020 ARVO Annual Meeting abstract.