Trabeculectomy with Amniotic Membrane Transplantation and Combining Suture Lysis of Scleral Flap in Complicated Glaucoma

OBJECTIVE:To study and evaluate the outcome of trabeculectomy with amniotic membrane transplantation combining suture lysis of scleral flap in complicated glaucoma.METHODS:This operation was performed in 48 patients (67 eyes) with complicated glaucoma. Amniotic membrane was implanted under the scleral flap and the conjunctival flap and combined with suture lysis for scleral flap to control the outflow of the aqueous humor.RESULTS:Follow-up period ranged from 5 to 38 months (mean 19.5 months). The intraocular pressure (IOP) was lowered from (43.86 +/- 7.12) mm Hg (preoperative IOP) to postoperative (19.63 +/- 2.57) mm Hg (postoperative IOP) in neovascular glaucoma (t = 4.96, P < 0.001); from (40.31 +/- 4.79) mm Hg to (18.09 +/- 2.21) mm Hg in glaucoma after IOL implant (t = 3.54, P < 0.05); from (37.94 +/- 5.63) mm Hg to (20.14 +/- 3.15) mm Hg in aphakic glaucoma (t = 5.12, P < 0.05); from (32.48 +/- 3.98) mm Hg to (16.54 +/- 1.84) mm Hg in juvenile glaucoma (t = 4.23, P < 0.01); from (36.01 +/- 4.13) mm Hg to (18.11 +/- 3.40) mm Hg in uveitic glaucoma (t = 4.47, P < 0.01); from (34.43 +/- 5.28) mm Hg to (18.31 +/- 1.52) mm Hg in glaucoma after failure of conventional filtering operation (t = 2.05, P < 0.05). Statistical significant difference was found in the IOP before and after the operation. The rate of formation of functional bulb was 80.6%. There were no reject reaction and severe complications.CONCLUSION:Trabeculectomy with amniotic membrane transplantation combining suture lysis of scleral flap is a useful method in complicated glaucoma.