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

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.