Comparative Study Between Microperforating Trabecular Surgery And Nonperforating Trabecular Surgery

AIM:To evaluate the clinical effect and security of microperforating trabecular surgery(MPTS)with reticulated hyaluronic acid implant(SK Gel),and to compare the clinical effect of this surgical method with nonperforating trabecular surgery(NPTS)METHOD:89 eyes of 60 patients with open-angle glaucoma were involved in our retrospective study.MPTS with SK Gel implant was performed on 36 eyes of 24 patients and NPTS with SK Gel was performed on 53 eyes of 36 patients.Postoperatively,international chart,Humphery campimeter,Goldman tonometer,slip lamp microscope,et al were used to observe visual acuity,visual field,intraocular pressure(IOP),bleb and complications of patients.The data were statistically analyzed.RESULTS:The mean follow-up was 15.37±4.18 months(1～24 months).There was no statistical difference of visual acuity between MPTS with SK Gel implant and NPTS with SK Gel implant(p＞0.05). Statistically significant difference of mean IOP between the 2 groups was not found on pre-operative,post-operative 1^th,3^th,6^thmonth.The mean IOP on post-operative 9^th,12^th.24^thmonth was 13.53±1.35mmHg, 15.00±1.71mmHg,17.27±1.75mmHg in MPTS group respectively,while that in the NPTS group for the same time series was 15.46±2.96 mmHg,16.77±4.68 mmHg,18.40±1.314 mmHg respectively,the mean IOP of MPTS group was lower than that of NPTS group,the statistical difference was significant(p＜0.05).The quality successful rate was 94.4%,92.5%in MPTS group and NPTS group respectively,the complete successful rate was 80.6%,75.5%respectively.In the MPTS group,the rate of hyphema and macular edema was 19.4%and 13.9%;while that in the NPTS group for the same time series was 15.1%,15.1%respectively (p＞0.05).Conclusion:Micro-perforating trabecular sugrery with reticulated hyaluronic acid implant can efectively lower the IOP and protect the visual function of open-angle glaucoma.The post-operative complications were much less.Micro-perforating trabecular sugrery is a new and effective surgical method of healing open-angle glaucoma.The long-term effect of lowering IOP of micro-perforating trabecular surgery is superior to that of nonperforating trabecular surgery.