J Korean Ophthalmol Soc.  2020 Aug;61(8):929-939. 10.3341/jkos.2020.61.8.929.

Clinical Outcomes of Trabeculectomy with Amniotic Membrane Transplantation and Mitomycin C in Primary Open-Angle Glaucoma

• Moon S
• Lee J

• KMID: 2505313
• DOI: http://doi.org/10.3341/jkos.2020.61.8.929

Abstract

Purpose
To evaluate the short-term clinical outcomes of trabeculectomy with amniotic membrane transplantation (AMT) and mitomycinC (MMC) in patients with primary open-angle glaucoma (POAG).
Methods
This was a retrospective, comparative, and consecutive case series study. We reviewed the medical records of patientswith POAG who underwent trabeculectomy with AMT and MMC and compared the surgical outcomes according to AMTwith Kaplan-Meier survival analysis. All patients had follow-up of ≥6 months. Surgical success was defined as an intraocularpressure (IOP) ≤18 mmHg and IOP reduction ≥20% without medication. We evaluated the frequency of complications and blebmorphology according to AMT.
Results
A total of 95 eyes of 79 patients were included; 52 eyes of 46 patients with AMT (AMT group) and 43 eyes of 33 patientswithout AMT (control group). The cumulative probability of success after trabeculectomy was 94.2% and 85.8% after one year forthe AMT and control groups, respectively (p= 0.121). Mean IOP decreased from 30.2 ± 9.8 mmHg preoperatively to 11.6 ± 4.2mmHg at the final visit in the AMT group (p< 0.001). Mean IOP decreased from 29.7 ± 7.4 mmHg preoperatively to 12.2 ± 4.5mmHg at the final visit in the control group (p< 0.001). Preoperative and final IOP were not significantly different between the twogroups. Complications were comparable between the groups. However, avascular cystic bleb was more frequent in the controlgroup (18.6%) than in the AMT group (0%) (p= 0.002).
Conclusions
Trabeculectomy with AMT and MMC appears to be a safe and effective procedure for IOP reduction in patientswith POAG, without development of avascular cystic bleb or bleb-related infection.

Keyword

Amniotic membrane; Bleb; Trabeculectomy; Primary open-angle glaucoma