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

Purpose: To evaluate the short-term clinical outcomes of trabeculectomy with amniotic membrane transplantation (AMT) and mitomycin C (MMC) in patients with primary open-angle glaucoma (POAG). Methods: This was a retrospective, comparative, and consecutive case series study. We reviewed the medical records of patients with POAG who underwent trabeculectomy with AMT and MMC and compared the surgical outcomes according to AMT with Kaplan-Meier survival analysis. All patients had follow-up of >= 6 months. Surgical success was defined as an intraocular pressure (IOP) <= 18 mmHg and IOP reduction >= 20% without medication. We evaluated the frequency of complications and bleb morphology according to AMT. Results: A total of 95 eyes of 79 patients were included; 52 eyes of 46 patients with AMT (AMT group) and 43 eyes of 33 patients without AMT (control group). The cumulative probability of success after trabeculectomy was 94.2% and 85.8% after one year for the AMT and control groups, respectively (p = 0.121). Mean IOP decreased from 30.2 +/- 9.8 mmHg preoperatively to 11.6 +/- 4.2 mmHg at the final visit in the AMT group (p < 0.001). Mean IOP decreased from 29.7 +/- 7.4 mmHg preoperatively to 12.2 +/- 4.5 mmHg at the final visit in the control group (p < 0.001). Preoperative and final 10P were not significantly different between the two groups. Complications were comparable between the groups. However, avascular cystic bleb was more frequent in the control group (18.6%) than in the AMT group (0%) (p = 0.002). Conclusions: Trabeculectomy with AMT and MMC appears to be a safe and effective procedure for IOP reduction in patients with POAG, without development of avascular cystic bleb or bleb-related infection.