The primary efficacy of trabeculectomy with immersion of mitomycin C and amniotic membrane implantation for refractory glaucoma

Objective To evaluate the short-term efficacy of trabeculectomy with immersion of mitomycin C and amniotic membrane implantation for refractory glaucoma. Methods Nine patients (10 eyes) of refractory glaucoma underwent trabeculectomy with immersion of mitomycin C and amniotic membrane implantation. Trabeculectomy was performed with a limbal-based conjunctival flap using 0. 4 mg/mL MMC for 3~5 min. A 6 mm x9 mm amniotic membrane was then placed under the scleral flap with 10-0 nylon suture. This group included 5 cases (6 eyes) of neovascular glaucoma, 2 (2 eyes) primary chronic angle-closure glaucoma, 1(1 eye) primary open-angle glaucoma and 1(1 eye) pseudophakic glaucoma. Results One month postoperatively, the intraocular pressure (IOP) was less than or equal to 21 mmHg in 8 eyes. The visual acuity of 5 eyes improved , 5 eyes not changed. After six months follow-up of the 7 eyes, IOP in 5 eyes was less than 21 mmHg,with appeared type Ⅰ bleb or type Ⅱ bleb. The visual acuity improved or not change in 5 eyes, reduced in 2 eyes because of fundus disease. The complications included transient hyphema, early shallow anterior chamber and exudative choroidal detachment. Conclusion Trabeculectomy with immersion of mitomycin C and amniotic membrane implantation is an effective method in the management of refractory glaucoma.