Trabeculotomo-ectomy Combined With Amniotic Membrane Grafting For The Treatment Of Congenital Glaucoma

ObjectiveTo observe the clinical efficacy and safety of trabeculotomo-ectomy(combined sugery of trabeculotomy and trabeculectomy) combined with amniotic membrane grafting for the treatment of primary congenital glaucoma. MethodsA retrospective analysis method study.Forty-seven eyes of 26 patients with primary congenital glaucoma were treated with the operation of traeculotomo-ectomy combined with amniotic membrane grafting. The intraocular pressure, corneal diameter, transparency of cornea,length of sagittal axis, filter bleb and complication were observed on the 2weeks,1,6,12,18,24 months after surgery, the therapeutic effect were analyzed. Results1. The clinical symptomsCollected 26 cases of patients with primary congenital glaucoma with 47 eyes, these eyes have obvious photophobia, tear, corneal opacity or big eye before surgery. After surgery this symptoms were relieved or disappeared.2. The intraocular pressure, length of eye axis, corneal diameter and C/D ratioPreoperative intraocular pressure was(37.80±11.24)mm Hg(1 mm Hg=0.133 k Pa), the length of eye axis was(26.72±2.43)mm, the corneal diameter was(13.31±0.61)mm, and the C/D ratio was 0.61±1.53. Followed up for 12-24 months. The average IOP at 2weeks,1,6,12,18 and 24 months after surgery was significant different from the preoperative level(P<0.05).The functional filtering blet formed in 29 eyes accounting for 61.70%. Follow up three months after operation shows that the axis shortening significantly compared with the preoperative(P<0.05), and the corneal diameter and C/D ratio were no significant different compared with the preoperative(P>0.05). The IOP of two eyes were uncontrolled by the anti-glaucoma medication at the time of 18 months and 24 months after surgery, then the two eyes were preoperation. The cornea of 37 eyes(88.10%, 37/42) was transparent after the surgery and the corneal edema alleviated obviously in 5 eyes(11.9%, 5/42) after the surgery. No obvious complications occurred.ConclusionTrabeculotomo-ectomy combined with amniotic membrane grafting can effectively decrease the IOP of congenital glaucoma. The operation is a safe and effective method for the treatment of congenital glaucoma.