Advertisement

International Ophthalmology

, Volume 38, Issue 5, pp 1933–1940 | Cite as

Retrospective observation on trabeculectomy of primary congenital glaucoma by applying biological amniotic membranes soaked with 5-fluorouracil

  • Chenming Zhang
  • Jing Wang
  • Hui Gao
  • Xiuqin Wang
  • Min Wu
  • Bailing Guo
  • Chunlei Liu
  • Wei Liu
Original Paper
  • 71 Downloads

Abstract

Purpose

To report our experience on treatment of primary congenital glaucoma with trabeculectomy in combination with biological amniotic membranes soaked with 5-fluorouracil.

Methods

This is a retrospective study. Thirty primary congenital glaucoma (PCG) patients (41 eyes) were treated with trabeculectomy in combination with biological amniotic membranes soaked with 5-fluorouracil before operation and followed up for 2.75 ± 1.35 years in average ranging from 1.2 to 5.3 years (Group A). In addition, 22 PCG patients (32 eyes) treated with mitomycin C-trabeculectomy were selected as control and followed up for 2.3 ± 1.25 years in average ranging from 1.4 to 5.1 years (Group B).

Results

Patients in Group A were 4.74 ± 2.13 years old. After treatment, their mean intraocular pressure decreased from preoperative 38.8 ± 11.3–17.6 ± 8.2 mmHg at 12 months of postoperation (P = 0.0000). At 12 months of follow-up, the intraocular pressure was less than 13 mmHg in 8 eyes (19.5%), between 17 and 13 mmHg in 15 eyes (36.6%), between 21 and 17 mmHg in 12 eyes (29.3%) and more than 21 mmHg in 6 eyes (14.6%). The overall success rate was 85.4%, and total complication rate was 17.1%. By comparison, the overall success rate and total complication rate were 87.5 and 34.4%, respectively, at 12 months of follow-up for patients in Group B. Although the overall success rate was not significantly different between Groups A and B (P = 0.1203) at the end of follow-up, the total complication rate was significantly decreased in Group A (P = 0.0419).

Conclusion

Application of trabeculectomy in combination with biological amniotic membranes soaked with 5-fluorouracil can be an effective surgical treatment method for primary congenital glaucoma patients.

Keywords

Primary congenital glaucoma Trabeculectomy Amniotic membrane 5-fluorouracil 

Notes

Acknowledgements

This study was supported by the Jinan City Health Science and Technology Development Plan (2008-13), the Jinan City Clinical Technology Development Plan (201503023) and the Shandong Provincial Science and Technology Department Key Research and Development Project (2015GSF118066).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Cai Y, Li MY, Sheng YY, Liu LN (2004) Long-term effect of trabeculectomy for treatment primary congenital glaucoma. Chin J Ophthalmol 11:733–736Google Scholar
  2. 2.
    Beauchamp GR, Parkes MM (1997) Filtering surgery in children: barriers to success. Ophthalmology 86:170–180CrossRefGoogle Scholar
  3. 3.
    El Sayed Y, Awadein A (2013) Polypropylene vs silicone Ahmed valve with adjunctive mitomycin C in paediatric age group: a prospective controlled study. Eye (Lond) 27:728–734CrossRefGoogle Scholar
  4. 4.
    Mahdy RA, Al-Mosallamy SM, Al-Aswad MA, Bor’i A, El-Haig WM (2016) Evaluation the adjunctive use of combined bevacizumab and mitomycinc totrabeculectomy in management of recurrent pediatric glaucoma. Eye (Lond) 30:53–58CrossRefGoogle Scholar
  5. 5.
    Green E, Wilkins M, Bunce C, Wormald R (2014) 5-fluorouracil for glaucoma surgery. Cochrane Database Syst Rev 19:1–33Google Scholar
  6. 6.
    Xue X, Gao Y (2013) Clinical observation of bio-amnion implantation used in combined trabeculectomy for refractory glaucoma. Int Eye Sci 13:944–946Google Scholar
  7. 7.
    Morales J, Al Shahwan S, Al Odhayb S, Al Jadaan I, Edward DP (2013) Current surgical options for the management of pediatric glaucoma. J Ophthalmol 2013:763–765CrossRefGoogle Scholar
  8. 8.
    Lu R, Ji J (2005) Application of grafts in trabeculectomy of Glaucoma. Sect Ophthalmol Foreign Med Sci 29:395–399Google Scholar
  9. 9.
    Danysh BP, Duncan MK (2009) The amniotic membrane. Exp Eye Res 88:151–164CrossRefPubMedCentralGoogle Scholar
  10. 10.
    Sarfarazi M, Stoilov I (2000) Molecular genetics of primary congenital glaucoma. Eye 14:422–428CrossRefPubMedCentralGoogle Scholar
  11. 11.
    Qiao CY, Tang X, Wang NL, Sun L, Zhang SX (2009) The correlation of clinical feature in primary congenital glaucoma. Chin J Pract Ophthalmol 27:969–972Google Scholar
  12. 12.
    Chew EY, Klein ML, Ferris FL, Remaley NA, Murphy RP, Chantry K et al (1996) Association of elevated serum lipid levels with retinal hard exudate in diabetic retinopathy. Early treatment diabetic retinopathy study (ETDRS) report 22. Arch Ophthalmol 114:1079–1084CrossRefPubMedCentralGoogle Scholar
  13. 13.
    AI-Hazmi A, Awad A, Zwaan J, Al-Mesfer SA, Al-Jadaan I, Al-Mohammed A (2005) Correlation between surgical success rate and severity of congenital glaucoma. Br J Ophthalmol 89:449–453CrossRefGoogle Scholar
  14. 14.
    Van Overdam KA, De Faber JT, Lemij HG, de Waard PW (2006) Baerveldt glaucoma implant in pediatric patients. Br J Ophthalmol 90:328–332CrossRefPubMedCentralGoogle Scholar
  15. 15.
    Mandal AK, Cothwal VK, Bagga H (2003) Outcome of surgery on infants younger than l month with congenital glaucoma. Ophthalmology 110:1909–1915CrossRefPubMedCentralGoogle Scholar
  16. 16.
    Campos-Mollo E, Moral-Cazalla R, Belmonte-Martlnez J (2008) Combined trabeculotomy- trabeculectomy as the initial surgical procedure of primary developmental glaucoma. Arch Soc Esp Oftalmol 83:479–485CrossRefPubMedCentralGoogle Scholar
  17. 17.
    Han D (2012) Clinical treatment research of primary congenital glaucoma. Int J Ophthalmol 12:644–646Google Scholar
  18. 18.
    Wang XB, Liu LM, Tang GX, Chen H, Guo JX, Lu WS (2011) Observations of efficacy on external trabecular incision in combination with trabeculectomy for treatment primary congenital glaucoma. Chin J Pract Ophthalmol 29:255–257Google Scholar
  19. 19.
    Chang I, Caprioli J, Ou Y (2017) Surgical management of pediatric glaucoma. Dev Ophthalmol 59:165–178CrossRefPubMedCentralGoogle Scholar
  20. 20.
    Chan JYY, Choy BNK, Ng ALK, Shun JWH (2015) Review on the management of primary congenital glaucoma. J Curr Glaucoma Pract 9:92–99CrossRefGoogle Scholar
  21. 21.
    Jalil A, Au L, Khan I, Ashworth J, Lloyd IC, Biswas S (2011) Combined trabeculotomy-trabeculectomy augmented with 5-fluorouracil in pediatric glaucoma. Clin Exp Ophthalmol 39:207–214CrossRefPubMedCentralGoogle Scholar
  22. 22.
    Tanimoto SA, Brandt JD (2006) Options in pediatric glaucoma after angle surgery has failed. Curr Opin Ophthalmol 17:132–137CrossRefPubMedCentralGoogle Scholar
  23. 23.
    Sheha H, Kheirkhah A, Taha H (2008) Amniotic membrane transplantation in trabeculectomy with mitomycin C for refractory glaucoma. J Glaucoma 17:303–307CrossRefPubMedCentralGoogle Scholar
  24. 24.
    Kubo M, Sonoda Y, Muramatsu R, Usui M (2001) Immunogenicity of human amniotic membrane in experimental xenotransplantation. Invest Ophthalmol Vis Sci 42:1539–1542PubMedPubMedCentralGoogle Scholar
  25. 25.
    Zhang C, Wu X, Liu W (2013) Impact of application of bio-amniotic membrane immersed in 5-fluorouracil solution in trabeculectomy on rabbit retina. Indian J Ophthalmol 61:734–738CrossRefPubMedCentralGoogle Scholar
  26. 26.
    Zhang CM, Guo BL, Wang JR, Liu W, Sun Y (2010) Application of anti-proliferative drugs soaked biological amniotic membrane in trabeculectomy. Recent Adv Ophthalmol 30:144–146Google Scholar
  27. 27.
    Wu SC, Huang SC, Kuo CL, Lin KK, Lin SM (2002) Reversal of optic disc cupping after trabeculotomy in primary congenital glaucoma. Can J Ophthalmol 37:337–341CrossRefPubMedCentralGoogle Scholar
  28. 28.
    Zhang X, Du S, Fan Q, Peng S, Yu M, Ge J (2009) Long-term surgical outcomes of primary congenital glaucoma in China. Clinics (Sao Paulo) 64:543–551CrossRefGoogle Scholar
  29. 29.
    Yalvac IS, Satana B, Suveren A, Eksioglu U, Duman S (2007) Success of trabeculotomy in patients with congenital glaucoma operated on within 3 months of birth. Eye 21:459–464CrossRefPubMedCentralGoogle Scholar
  30. 30.
    Sidoti PA, Belmonte SJ, Liebmann JM, Ritch R (2000) Trabeculectomy with mitomycin-C in the treatment of pediatric glaucomas. Ophthalmology 107:422–429CrossRefPubMedCentralGoogle Scholar
  31. 31.
    Papadopoulos M, Cable N, Rahi J, Khaw PT (2007) BIG eye study investigators the british infantile and childhood glaucoma (BIG) eye study. Invest Ophthalmol Vis Sci 48:4100–4106CrossRefPubMedCentralGoogle Scholar
  32. 32.
    Khairy HA, Elsawy MF (2015) Trabeculectomy with mitomycin-c versus trabeculectomy with amniotic membrane transplant: a medium-term randomized, controlled trial. J Glaucoma 24:556–559CrossRefPubMedCentralGoogle Scholar
  33. 33.
    Jayaram H, Scawn R, Pooley F, Chiang M, Bunce C, Strouthidis NG, Khaw PT (2015) Long-term outcomes of trabeculectomy augmented with mitomycin C undertaken within the first 2 years of life. Ophthalmology 122:2216–2222CrossRefPubMedCentralGoogle Scholar
  34. 34.
    Ghate D, Kedar S (2015) Surgical interventions for primary congenital glaucoma. Cochrane Database Syst Rev 1:CD008213PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  • Chenming Zhang
    • 1
  • Jing Wang
    • 2
  • Hui Gao
    • 2
  • Xiuqin Wang
    • 3
  • Min Wu
    • 4
  • Bailing Guo
    • 5
  • Chunlei Liu
    • 5
  • Wei Liu
    • 1
  1. 1.Eye Reseach InstituteJinan Eye HospitalJinanPeople’s Republic of China
  2. 2.Infection Control DepartmentJinan Eye HospitalJinanPeople’s Republic of China
  3. 3.Quality Control OfficeJinan Eye HospitalJinanPeople’s Republic of China
  4. 4.Nursing DepartmentJinan Eye HospitalJinanPeople’s Republic of China
  5. 5.Ophthalmology DepartmentJinan Eye HospitalJinanPeople’s Republic of China

Personalised recommendations