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. 2020 Oct 9:2020:3949735.
doi: 10.1155/2020/3949735. eCollection 2020.

Effectiveness and Safety of Trabeculectomy along with Amniotic Membrane Transplantation on Glaucoma: A Systematic Review

Tian-Yi Shen  1   2 , Wei-Nan Hu  3 , Wen-Ting Cai  1 , Hui-Zi Jin  1 , Dong-Hui Yu  1 , Jing-Hui Sun  2 , Jing Yu  1   2
Affiliations

Effectiveness and Safety of Trabeculectomy along with Amniotic Membrane Transplantation on Glaucoma: A Systematic Review

Tian-Yi Shen et al. J Ophthalmol. .

Abstract

Purpose: To determine the effectiveness and safety of trabeculectomy along with amniotic membrane transplantation (AMT) for glaucoma.

Methods: This systematic review was performed using RevMan 5.3. We searched PubMed, EMBASE, and the Cochrane Library and included studies published until September 2019. The treatment group included patients with AMT and trabeculectomy (group A), and the control group had only trabeculectomy (group B). We only included randomized controlled trials. The outcomes were intraocular pressure (IOP), complete success rate, number of antiglaucoma medications, and complications.

Results: Five studies, including 174 eyes (87 eyes in the AMT group and 87 eyes in the control group), were eligible in this review. The parameters had no significant difference in heterogeneity between the AMT and control groups preoperatively. In the AMT group, the mean IOP was significantly lower at 3 and 12 months after operation (P < 0.0001 and P = 0.02, respectively), while the number of complete successes in the AMT group was significantly higher at 6 and 12 months (P = 0.02 and P = 0.003, respectively) compared with the control group. Complications, including a flat anterior chamber and hyphema, appeared to be decreased in the AMT group compared to the control group (P = 0.02 and P = 0.02, respectively). No differences were observed in the number of antiglaucoma medications, hypotony, encapsulated bleb, or choroidal detachment.

Conclusion: Compared with only trabeculectomy, it is more efficient and safer to add AMT to trabeculectomy during glaucoma filtering surgery.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of search strategy in this systematic review. RCT, randomized controlled clinical trial.
Figure 2
Figure 2
Methodological quality summary: authors' judgments about each methodological quality item for each included study. Note: + represents yes; ? represents unclear.
Figure 3
Figure 3
Forest plot comparison of IOP after treatment in the AMT and control group (a) preoperatively, (b) three months postoperatively, (c) six months postoperatively, and (d) one year postoperatively.
Figure 4
Figure 4
Forest plot comparison of the number of eyes with complete success after treatment in AMT and control group. (a) Six months postoperatively; (b) One year postoperatively.
Figure 5
Figure 5
Forest plot comparison of the number of antiglaucoma medications after treatment in the AMT and control group (a) preoperatively and (b) one year postoperatively.
Figure 6
Figure 6
Forest plot comparison of complications after treatment in the AMT and control group. (a) Hypotony. (b) Flat anterior chamber. (c) Hyphema. (d) Encapsulated bleb. (e) Choroidal detachment.
See this image and copyright information in PMC

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