A freeze-dried (lyophilized) amniotic membrane transplantation with mitomycin C and trabeculectomy for pediatric glaucoma

Abstract

Purpose: To evaluate the potential usefulness of a freeze-dried (lyophilized) amniotic membrane transplantation with mitomycin C (MMC) in the maintenance of functioning glaucoma surgery in cases of pediatric glaucoma.

Methods: Thirty eyes of pediatric patients with glaucoma were included in this study. Trabeculectomy with amniotic membrane implantation and MMC was done in group 1 (15 eyes), and trabeculectomy with MMC only was done in group 2 (15 eyes). The preserved amniotic membrane was placed over the scleral flap and under the conjunctiva. The mean intraocular pressure (IOP) was measured pre- and postoperatively and bleb appearance was noted. The follow-up time was 18 months after surgery.

Results: The mean postoperative IOP was significantly decreased to 15 +/- 1 mm Hg and 17.2 +/- 2.9 mm Hg in the 2 groups, respectively. The bleb was functioning well in the follow-up period in most of the cases, except 5 cases that needed another surgery. Complications such as inflammation, choroidal detachment, or toxic keratopathy were not noted in group 1 but were noted in group 2.

Conclusion: Trabeculectomy with amniotic membrane transplantation and MMC can effectively control the elevated IOP in pediatric patients with glaucoma without significant postoperative complications.