Abstract:
Background: Long term success of trabeculectomy is largely depende
nt on modulation of postoperative wound healing. Conventional
sponge-applied mitomycin-C (MMC), although effective, is associated
with variability in dosing and bleb-related complications. Sub-tenon
MMC injection and amniotic membrane transplantation (AMT) have
emerged as adjuncts aimed at improving bleb quality and surgical
safety.
Aim: To evaluate the efficacy and safety of trabeculectomy augmented
with sub-tenon MMC and amniotic membrane transplantation in
patients with glaucoma.
Materials and Methods: This prospective interventional study include
d 21 patients with medically uncontrolled primary open-angle or
primary angle-closure glaucoma.All patients underwent trabeculectomy
with standardized sub-tenon MMC injection followed by placement of
cryopreserved amniotic membrane over the scleral flap. Pre- and
postoperative intraocular pressure (IOP), anti-glaucoma medication
requirement, bleb morphology, complications, and surgical outcomes
were assessed during follow-up.
Results: The majority of patients were above 50 years of age with a
slight male predominance. Primary open-angle glaucoma was the most
common type (76.2%). Mean IOP decreased from 28.4 ± 4.6 mmHg
preoperatively to 14.2 ± 2.8 mmHg at 1 month and 13.6 ± 2.4 mmHg at
3 months postoperatively. Postoperatively, 71.4% of patients required
no antiglaucoma medications. Diffuse functioning blebs were observed
in 76.2% of eyes. Postoperative complications were minimal. Complete
surgical success was achieved in 66.7% of patients, while qualified
success was observed in 23.8%.
Conclusion: Sub-tenon MMC-augmented trabeculectomy combined
with AMT provides effective IOP control, favorable bleb morphology,
and a low complication profile, representing a promising surgical
approach in glaucoma management.
