Simultaneous Use of Amniotic Membrane and Mitomycin C in Trabeculectomy for Primary Glaucoma: A Pilot Study

Yadava, Usha; Jaisingh, Kirti; Dangda, Sonal; Thacker, Prolima; Singh, Kehar; Goel, Yashpal

doi:10.4172/2155-9570.1000604

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…The amniotic membrane has anti-scarring and anti-inflammatory properties in fibrotic eye disease, including glaucoma surgery [10‒12, 37, 38]. The anti-scarring effect of the amniotic membrane is mediated by downregulating TGF-β signalling pathway and myofibroblast differentiation.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies reported that trabeculectomy with amniotic membrane transplantation (AMT) had a lower complication rate and higher success rate than trabeculectomy without AMT [10‒12]. In our previous study, trabeculectomy with AMT was found to be a safe and effective method for intraocular pressure (IOP) reduction in patients with primary open-angle glaucoma (POAG) without the development of avascular cystic blebs or bleb-related infection [12].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the Intrableb Characteristics of Anterior Segment Optical Coherence Tomography Imaging in Trabeculectomy according to Amniotic Membrane Transplantation

Moon¹,

Kim²,

Lee³

2023

Ophthalmic Res

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Introduction: The purpose of this study was to compare the characteristics of filtering bleb with anterior segment optical coherence tomography (AS-OCT) according to amniotic membrane transplantation (AMT). Methods: One hundred and sixteen eyes of 103 glaucoma patients who underwent trabeculectomy with (AMT group; 85 eyes) or without AMT (control group; 31 eyes) were included. Intrableb parameters were evaluated with AS-OCT. Surgical success was defined as an intraocular pressure (IOP) ≤18 mm Hg and IOP reduction ≥20% without medication at the time of AS-OCT examination. Logistic regression analyses were performed to determine factors associated with IOP control. Results: In the eyes with successful IOP control, the fluid-filled space area, score, and height were greater for the AMT group than the control group (all ps < 0.001), while stripping layer thickness was greater and bleb wall reflectivity was lower for the control group than the AMT group (all ps < 0.001). Surgical success in the AMT group was associated with greater fluid-filled space score, lower bleb wall reflectivity, and microcyst formation (odds ratio [OR] = 8.016, 0.913, and 16.202, respectively, all ps ≤ 0.041). Lower bleb wall reflectivity alone was associated with surgical success in the control group (OR = 0.815, p = 0.019). Conclusion: The extent of the fluid-filled space was associated with successful IOP control after trabeculectomy with AMT. Hyporeflective bleb wall was associated with successful IOP control in AMT and control groups.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of the Intrableb Characteristics of Anterior Segment Optical Coherence Tomography Imaging in Trabeculectomy according to Amniotic Membrane Transplantation

Moon¹,

Kim²,

Lee³

2023

Ophthalmic Res

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“…AM is known to reduce scarring at the time of the filtering surgery; repair any early or late blebs and act as a protective cover in valve procedures [ 43 ]. When used in conjunction with any glaucoma surgery, AM transplantation is used to protect and cover any exposed sclera to improve both patient outcomes and the rate of complications [ 44 , 45 ]. It should be noted that as AM is a human tissue, it can have variable persistence time dependent on the inflammation present at the ocular surface and the method of application.…”

Section: Glaucomamentioning

confidence: 99%

“…First reported by Fujishima et al [ 47 ] the surgical procedure for AMtransplantation following trabeculectomy is yet to be standardised. Some studies report the placement of the AM below of scleral flap in a ‘inlay-graft’ fashion [ 48 , 49 ], however, other studies state that the tissue is placed over the wound in an ‘onlay-graft’ fashion to over the entire exposed scleral bed [ 32 , 44 , 50 ]. As a whole, data shows the application of AM epithelial-side-down [ 2 ] when placed onto the wound.…”

Section: Glaucomamentioning

confidence: 99%

The developments in amniotic membrane transplantation in glaucoma and vitreoretinal procedures

2023

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The main reasons why Amniotic Membrane (AM) is transplanted in Ophthalmology are: to provide a substrate for cellular growth and to provide tectonic support or as a biological bandage and barrier that protects the wound to facilitate an environment for wound healing. The application of AM is well-documented in corneal disorders of various aetiologies [1], however, research within the field has highlighted how it can be used in conjunctival disorders and most recently, in glaucoma and vitreoretinal procedures. This review explores the preservation modalities of AM and summarises the current literature regarding AM transplantation in Glaucoma and Vitreoretinal conditions. AM transplantation in conjunction with trabeculectomy was reported to be used in two different surgical techniques. They differ in relation to the position of the implant: below the scleral flap or over the entire exposed sclera. The results of these studies suggest that AM transplant is a safe procedure that helps in the improvement of the intraocular pressure when associated with trabeculectomies. Moreover, it enhances trabeculectomies success rates when used along with mitomycin C [2]. The use of AM is also described for managing leaking blebs. It is mentioned to be a suitable alternative to conjunctival advancement. Regarding AM transplantation in glaucoma shunt or valve surgeries, the current literature is relatively limited. However, AM has been described as a good tectonic support for shunt procedures [3]. Successful results are described in the literature for surgical treatments using AM plug for vitreoretinal procedures. In particular macular hole closure and rhegmatogenous retinal detachment. In conclusion, AM transplant is a very promising and versatile adjutant therapy. However, further studies are also required for a better understanding and refinement of surgical techniques.

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Clinical Outcomes of Trabeculectomy with Amniotic Membrane Transplantation and Mitomycin C in Primary Open-Angle Glaucoma

Moon¹,

Lee²

2020

J Korean Ophthalmol Soc

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Simultaneous Use of Amniotic Membrane and Mitomycin C in Trabeculectomy for Primary Glaucoma: A Pilot Study

Cited by 3 publications

References 8 publications

Comparison of the Intrableb Characteristics of Anterior Segment Optical Coherence Tomography Imaging in Trabeculectomy according to Amniotic Membrane Transplantation

Comparison of the Intrableb Characteristics of Anterior Segment Optical Coherence Tomography Imaging in Trabeculectomy according to Amniotic Membrane Transplantation

The developments in amniotic membrane transplantation in glaucoma and vitreoretinal procedures

Clinical Outcomes of Trabeculectomy with Amniotic Membrane Transplantation and Mitomycin C in Primary Open-Angle Glaucoma

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