Clinical investigation of trabeculectomy combined with amniotic membrane insertion under the scleral flap to treat refractory glaucoma

Objective To evaluate the clinical effect of trabeculectomy combined with amniotic membrane insertion under the scleral flap to treat patients with refractory glaucoma. Methods Thir- ty-five eyes of 28 patients with glaucoma underwent trabeculectomy combined with amniotic mem-brane insertion under the scleral flap. The filtering bleb, intraocular pressure, the success rate of the operation and complications were observed after surgery. Results After 3～24 months of follow-up, 34 eyes had type Ⅰ blebs, 9 eyes had type Ⅱ blebs, 2 eyes had type Ⅲ blebs and 3 eyes had type Ⅳ blebs. The average intraocular pressure was controlled at (13.1±2.6)mmHg after 3 months and (15.4±3.1)mmHg 12 months after surgery. Drugs were used in 2 eyes to control intraocular pressure. The total success rate of the operation was 94.3%(33/35). Five eyes with anterior chamber exudation and 1 eye diagnosed with neovascular glaucoma with a small hyphema were found post surgery, but they all recovered within a week. Conclusion Combined trabeculectomy with amniotic membrane insertion under the scleral flap can increase the success rate of glaucoma surgery. Key words: Trabeculectomy; Amniotic membrane ; Refractor glaucoma