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. 2021 Nov 27:15:4527-4533.
doi: 10.2147/OPTH.S342593. eCollection 2021.

Use of Amniotic Membrane in MMC-Augmented Trabeculectomy: A Retrospective Comparative Study

Joana Roque  1 , Fernando Trancoso Vaz  1 , Rita Basto  1 , Susana Henriques  1 , Ana Sofia Lopes  1 , Diana Silva  1 , Jorge Santos  2 , Graça Pires  1 , Maria Lisboa  1 , Isabel Prieto  1
Affiliations

Use of Amniotic Membrane in MMC-Augmented Trabeculectomy: A Retrospective Comparative Study

Joana Roque et al. Clin Ophthalmol. .

Abstract

Purpose: Amniotic membrane transplantation (AMT) has shown promising results as an antifibrotic agent in trabeculectomy. We aimed to evaluate the additional effect of AMT in MMC-augmented trabeculectomy.

Patients and methods: This retrospective study analyzed the results of the first 12 postoperative months of glaucomatous eyes submitted to Moorfields Safer Surgery Trabeculectomy with MMC alone (non-AMT group) compared to MMC and AMT (AMT group). Both groups were compared in terms of intraocular pressure (IOP), number of antihypertensive medications and need for surgical reinterventions. Absolute and relative success rates 12 months after surgery were defined as IOP <18 mmHg, without and with the use of antihypertensive medications, respectively.

Results: The analysis included 51 eyes of 45 glaucoma patients (29 eyes in the non-AMT group and 22 in the AMT group). Mean IOP decreased from 24.72±5.11 mmHg and 26.86±10.62 mmHg preoperatively in non-AMT and AMT groups to 12.86±4.22 mmHg and 12.60±4.43 mmHg, respectively, at 12 months (p = 0.84). Postoperative number of medications decreased significantly in both groups. Absolute success was seen in 71% of non-AMT eyes and 55% of AMT eyes (p = 0.46), whereas relative success was obtained in 14% and 30%, respectively (p = 0.55). Reinterventions were needed in 28% of the eyes (11 bleb injection/needling and 4 Ahmed tube implantation) in the non-AMT group and in 27% of the AMT group (10 bleb injection/needling and 1 Ahmed tube implantation) (p = 0.89).

Conclusion: Trabeculectomy combined with MMC and AMT did not show better results than trabeculectomy with MMC alone.

Keywords: amniotic membrane; antifibrotics; glaucoma; mitomycin C; scarring; trabeculectomy.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Amniotic membrane above the scleral flap (stromal surface facing down).
Figure 2
Figure 2
Large and diffuse filtration bleb registered in one of the eyes of the AMT group.
Figure 3
Figure 3
Preoperative and postoperative mean IOP during follow-up period. We present mean IOP values in each study group. The bars represent the standard error at each follow-up visit. Vertical axis - Mean IOP in each group; horizontal axis - preoperative and postoperative visits; solid line - non-AMT group; dashed line - AMT group.
Figure 4
Figure 4
Preoperative and postoperative mean number of antihypertensive medications during follow-up period. Representation of the mean number of antihypertensive medications used in each group, along with bars relative to the standard error at each timepoint. Vertical axis - mean number of antihypertensive medications in each group; horizontal axis - preoperative and postoperative visits; solid line - non-AMT group; dashed line - AMT group.
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