A comparison of amniotic membrane and Mitomycin C applied in glaucoma trabeculectomy

Objective To compare the anti-scarring effects of amniotic membrane and mitomycin C in glaucoma trabeculectomy. Methods Sixty-eight eyes of 38 cases of angle closure glaucoma were divided into mitomycin C (MMC) group and amniotic membrane group with 34 eyes in each group.In MMC group, the MMC with concentration of 0.3mg/ml was applied only once for 3 min. Patients in amniotic membrane group underwent trabeculectomy combined with amniotic membrane implantation under scleral flap. Patients were followed up for 10 months. Results The total success rate, including conditional success rate and cumulative complete success rate was 81.05% and the complete success rate was 62.03% in MMC group, and they were 94.02% and 82.09% in amniotic membrane group. The differences were statistically significant between two groups (χ2=2.403, P=0.238; χ2=2.101, P=0.210). Postoperative complications in amniotic membrane group included postoperative shallow anterior chamber in 6 eyes, cataract in 2 eyes, hyphema in 2 eyes and thin bleb in 2 eyes. Postoperative complications in MMC group were mainly shallow anterior chamber in 8 eyes, cataract in 7 eyes, hyphema in 9 eyes, thin-wall bleb in 9 eyes, leaking filtering blebs in 6 eyes, persistent hypotony in 9 eyes, and macular disease caused by low intraocular pressure in 6 eyes. Conclusion Amniotic membrane used in trabeculectomy can effectively prevent the scar formation of blebs in operation, and can effectively preserve the functional follicles for a long time with less complication than MMC. Key words: Glaucoma; Trabeculectomy; Mitomycin C; Amnion