Clinical Trial Of Trabeculectomy With Finished-product Amniotic Membrane Transplantion

Objective: To investigate the efficacy,security and feasibility of the finished-product amniotic membrane in trabeculectomy by observing the intraocular pressure(IOP),filtering belbs,inflammatory reaction of the anterior chamber,visual acuity and complication with 6 months. To evaluate the exact clinical effect of of the finished-product amniotic membrane in trabeculectomyMethods: A filtering operation of various types of glaucoma in patients with indications of 40 cases (40 eyes), in which acute angle closure glaucoma in 16 cases (16 eyes), chronic angle-closure glaucoma in 16 cases (16 eyes), the primary Open-angle glaucoma 8 cases (8 eyes), all patients were ruled out diabetes, hypertension, heart disease and other systemic diseases. All the patients,which were the initial surgery, all indications of filtering surgery, were randomly divided into experimental group (A) and the control group (B), each of 20 patients (20). Control group of conventional trabeculectomy, the experimental group and finished trabeculectomy line of amniotic membrane transplantation, and to do a six-month follow-up observation and analysis of the two groups before and after the 1d,2d,3d,1w,2w,3w,1m,2m and 6m of the intraocular pressure(IOP),filtering belbs,Inflammatory reaction of the anterior chamber,blood indicators,visual acuity and complication in normal circumstances.Results:①IOP:One day after operation,the mean IOP of two groups were decreased under 21mmHg.IOP was the lowest after three days of operation, and the IOP of group A was (8.15±2.88)mmHg , group B(12.75±2.67) mmHg. The IOP in 1d,1w,1m,6m after operation was decreased expressly in two groups,(P<0.05).The IOP of group A was lower than that of group B after 1d,2d,3d,1w,2w,1m,2m,6m of operation, and there was significant difference between them.②Filtering bleb: After six months of operation,Type II filtering bleb 38, accounting for 95 percent.A parcel filtering bleb and a scar filtration bleb were in the group B.In the group A filtering bleb congestive obviously lighter than the group A after the first day of operation, which had a significant difference (P <0.05), while 7 days and 14 days each group filtering bleb congestive level close, the difference was not statistically significance.③Inflammatory reaction of the anterior chamber :In the group A , the anterior chamber obvious lighter than the group B after the first day of operation, which had a significant difference,while 7 days and 14 days each group close, the difference was not statistically significant.④The quantity of white blood cell and lymphocyte had no change pre-and postoperatively in 1,3,7 days respectively.There was no significant difference between the two groups and different days.⑤Visual acuity:The difference of the visual acuity of the two groups before and after 6 m was not significant.⑥Complicatios:2 eyes in group A which got type I shallow of anterior chamber afte 1day of operation because of excess filtration.They recoveried by mydriasis,compression bandaging after 4 days of operation. There were 2 eyes in group B which got bulbi hypertonia and they recoveried by demolishing the accommodative suture line and massage.All of the eyes had no complications of leaking blebs,infected blebs,ocular hypotension and macular edema.Conclusions:①The finished-product amniotic in the trabeculectomy application is safe and effective .②The finished-product amniotic can effectively reduce the inflammatory reaction of the anterior chamber and filtering congestive,checked filtering surgery scar formation, maintenance of functional water filtration, reduce intraocular pressure.