Abstract
Purpose :
To evaluate the effect of amniotic membrane transplantation (AMT) on trabeculectomy in patients with pseudoexfoliation glaucoma (PXG)
Methods :
We reviewed the medical records of patients with PXG who underwent fornix-based trabeculectomy with Mitomycin C with or without AMT. Kaplan-Meier survival curves were compared with log-rank test in AMT group and control group. All patients had follow-up of at least 12 months. Surgical success was defined by following 4 criteria. (1) Criteria A: intraocular pressure (IOP) ≤ 18 mmHg and IOP reduction 20% without medication; (2) Criteria B: IOP ≤ 15 mmHg and IOP reduction 25% without medication; (3) Criteria C: IOP ≤ 18 mmHg and IOP reduction 20% with or without medications; (4) Criteria D: IOP ≤ 15 mmHg and IOP reduction 25% with or without medications. Kaplan-Meier survival curves were compared with log-rank test in AMT group and control group. Cox proportional hazard models were used to estimate the influence of AMT on surgical success accounting for confounding variables.
Results :
52 eyes with AMT (AMT group) and 33 eyes without AMT (control group) were included in this retrospective study. Cumulative success rates were 86.5% at 12 months and 83.8% at 24 months for AMT group, and 63.6% and 56.3% for control group by criterion A. Complete success rates were significantly greater for AMT group than for control group by criteria A and B (P = 0.017, P = 0.005, respectively). Cumulative success rates were 92.1% at 12 months and 89.0% at 24 months for AMT group, and 75.1% and 62.8% for control group by criterion C. Qualified success rates were significantly greater for AMT group than for control group by criteria C and D (P = 0.047, P = 0.021, respectively). On multivariable Cox regression analyses, AMT was associated with higher success rate with all criteria for complete and qualified success (P ≤ 0.04 for all). Avascular bleb developed in 7 eyes (21.2%) of control group while there were no eyes with avascular bleb in AMT group (P = 0.004).
Conclusions :
In patients with PXG, trabeculectomy with AMT for target IOP ≤ 18 mmHg or ≤ 15 mmHg was more successful than trabeculectomy without AMT. Avascular bleb was found only after trabeculectomy without AMT.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.