Roque Joana, Vaz Fernando Trancoso, Basto Rita, Henriques Susana, Lopes Ana Sofia, Silva Diana, Santos Jorge, Pires Graça, Lisboa Maria, Prieto Isabel
Ophthalmology Department, Prof. Doutor Fernando Fonseca Hospital, Amadora, Lisbon, Portugal.
Department of Mathematics ECT, CIMA IIFA Évora University, Évora, Portugal.
Clin Ophthalmol. 2021 Nov 27;15:4527-4533. doi: 10.2147/OPTH.S342593. eCollection 2021.
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.
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.
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).
Trabeculectomy combined with MMC and AMT did not show better results than trabeculectomy with MMC alone.
羊膜移植（AMT）作为小梁切除术中的抗纤维化药物已显示出有前景的结果。我们旨在评估AMT在丝裂霉素C（MMC）辅助小梁切除术中的附加效果。
这项回顾性研究分析了仅接受莫菲尔德更安全手术小梁切除术联合MMC（非AMT组）与接受MMC和AMT（AMT组）的青光眼患者术后前12个月的结果。比较了两组的眼压（IOP）、抗高血压药物数量以及手术再次干预的必要性。术后12个月的绝对成功率和相对成功率分别定义为眼压<18 mmHg，分别为未使用和使用抗高血压药物的情况。
分析纳入了45例青光眼患者的51只眼（非AMT组29只眼，AMT组22只眼）。非AMT组和AMT组术前平均眼压分别从24.72±5.11 mmHg和26.86±10.62 mmHg降至术后12个月时的12.86±4.22 mmHg和12.60±4.43 mmHg（p = 0.84）。两组术后药物数量均显著减少。非AMT组71%的眼和AMT组55%的眼获得绝对成功（p = 0.46），而相对成功率分别为14%和30%（p = 0.55）。非AMT组28%的眼（11次滤泡注射/针刺和4次艾哈迈德管植入）和AMT组27%的眼（10次滤泡注射/针刺和1次艾哈迈德管植入）需要再次干预（p = 0.89）。
小梁切除术联合MMC和AMT并不比单纯MMC小梁切除术效果更好。
