Clinical observation of trabeculectomy combined with amniotic membrane transplantation in glaucoma filtering surgery

doi:10.3877/cma.j.issn.2095-2007.2017.04.005

Abstract

Abstract:

Objective

To observe the application of biological amniotic membrane in glaucoma filtration surgery.

Methods

Choose from March 2011 to March 2015, 78 patients (92 eyes) of angle closure glaucoma were treated in Shanghai Baoshan District traditional Chinese and Western medicine hospital, performed a retrospective analysis. All patients were randomly divided into 3 groups, underwent trabeculectomy in patients of 1 group, underwent trabeculectomy combined with amniotic membrane transplantation in patients of 2 groups, including group one of patients placed in the amniotic membrane under the scleral flap, group two were placed in the amniotic membrane under conjunctiva. All the operations were performed by the author, visual acuity, intraocular pressure, follicles, anterior chamber and complications were observed every day for one week after operation. After operation 6 months, the long diameter, and width diameter of the filtration bubble were measured by UBM. To compare the clinical effects of three surgical procedures.

Results

The best corrected visual acuity of the three groups before and after the operation was improved significantly, the difference was statistically significant (u=-4.99, P<0.05). Three groups of patients before and after 1 week, 1 month, 3 months and 6 months follow-up of intraocular pressure, there was significant difference between different time points (F=15.67, P<0.05), but there was no statistically significant differences between the three groups, (F_group=1.28, P>0.05). In the 2 groups, the time of local filtration and vesicle congestion was higher than that of the other two groups, and the filtering blebs were relatively flat. Three eyes with bleb length and width were compared, the difference was statistically significant (F=104.66, 20.40; P<0.05) further comparison of trabeculectomy with amniotic membrane group 2 group bleb, the difference was statistically significant (t=10.55, 8.97; P<0.05). There were 2 cases of anterior chamber I degree complications in the 2 groups of amniotic membrane. After mydriasis treatment, the recovery was in good condition. There were no severe complications such as malignant glaucoma and choroidal detachment in the 3 groups. The success rate of trabeculectomy was 81.81%, and the success rate was 91.67% in amniotic membrane group 1 and 2 in amniotic membrane group 88.24%. There was no significant difference between the three groups in the success rate of operation (χ₂=1.26, P>0.05).

Conclusion

Trabeculectomy combined with amniotic membrane transplantation is an effective method for the treatment of angle closure glaucoma. It has a high rate of operation, a marked decrease in the scarring of the filtering canal, and the formation of functional filtering blebs.

Key words: Glaucoma, Trabeculectomy, Biological amniotic membrane transplantation

Jianming Tang, Hao Lu, Jun Hu, Beijing Zhu, Yi Xiong, Jin Qian. Clinical observation of trabeculectomy combined with amniotic membrane transplantation in glaucoma filtering surgery[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2017, 07(04): 171-176.

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组别	眼数	时间
组别	眼数	术前	术后1周	术后1个月	术后3个月	术后6个月
小梁切除组	92	33.8±12.2	8.8±1.3^ac	12.3±3.3^abc	12.9±3.0^abc	15.2±3.7^ab
羊膜1组	92	31.9±11.8	7.9±1.5^ac	11.3±3.4^abc	12.3±4.2^abc	14.9±3.4^ab
羊膜2组	92	32.3±12.0	8.3±2.1^ac	11.9±4.1^abc	12.8±3.8^abc	15.3±4.1^ab

组别	眼数	时间
组别	眼数	术前	术后1周	术后1个月	术后3个月	术后6个月
小梁切除组	92	33.8±12.2	8.8±1.3^ac	12.3±3.3^abc	12.9±3.0^abc	15.2±3.7^ab
羊膜1组	92	31.9±11.8	7.9±1.5^ac	11.3±3.4^abc	12.3±4.2^abc	14.9±3.4^ab
羊膜2组	92	32.3±12.0	8.3±2.1^ac	11.9±4.1^abc	12.8±3.8^abc	15.3±4.1^ab

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