Use of amniotic membrane in trabeculectomy for the treatment of glaucoma: a pilot study

Abstract

Trabeculectomy with amniotic membrane and standard trabeculectomy promote lower postoperative intraocular pressure although results showed no statistically significant difference between groups regarding postoperative intraocular pressure after one year follow-up.

Device modified trabeculectomy for glaucoma

“…Eighteen studies, reported in 17 full-text articles and one conference abstract, assessed the use of amniotic membrane compared with trabeculectomy, with or without the use of MMC (Bruno 2008;Cai 2012;Cho 2013;Eliezer 2006;Huang 2007;Ji 2013;Khairy 2015;Li 2010;Liu 2009;Ren 2009;Sheha 2008;Stavrakas 2012;Wang 2008;Wang 2009;Yan 2004;Yang 2004;Zhang 2009;Zheng 2005). Findings from 13 of these studies were published in Chinese and accounted for 647 eyes of 536 participants, more than 70% of all 726 participants in the 18 studies.…”

“…Incomplete outcome data-Of the 33 studies, investigators of 17 studies reported few or no losses to follow-up, resulting in our assessment of them to be at low risk of attrition bias: four of six trials of Ex-PRESS (Dahan 2012;De Jong 2009;Netland 2014;Wagschal 2013), five of eight studies for Ologen (Cillino 2011;Marey 2013;Papaconstantinou 2010;Rosentreter 2010;Rosentreter 2014), six of 18 studies for amniotic membrane (Cai 2012;Eliezer 2006;Ji 2013;Khairy 2015;Liu 2009;Stavrakas 2012), one study for E-PTFE (Cillino 2008), and one study for Gelfilm (Birt 1998). Four studies had a relatively large percentage of losses to follow-up (> 10%) and we assessed the risk of attrition bias to be high for these studies (Bruno 2008;Cho 2013;Senthil 2013;Sheha 2008).…”

“…Studies judged to be at unclear risk of reporting bias by devices: one of eight studies for Ologen, two of 18 studies for amniotic membrane, the only study that evaluated E-PTFE (Bruno 2008;Cillino 2008;Cillino 2011;Ji 2013;Maheshwari 2012). The study for Gelfilm was at a high risk of reporting bias (Birt 1998), as were 11 of 18 studies for amniotic membrane (Cai 2012;Eliezer 2006;Huang 2007;Khairy 2015;Li 2010;Liu 2009;Ren 2009;Wang 2009;Yan 2004;Yang 2004;Zheng 2005).…”

“…At one year, nine studies comprising 356 eyes provided postoperative IOP data (Cai 2012;Eliezer 2006;Ji 2013;Khairy 2015;Li 2010;Liu 2009;Ren 2009;Sheha 2008;Wang 2009). The low-quality evidence showed that the use of amniotic membrane may slightly improves IOP reduction (Analysis 3.1; Figure 5; MD −3.92 mm Hg, 95% CI −5.41 to −2.42; I 2 = 84%).…”

“…Choroidal detachment: Four studies including 187 eyes reported this complication (Eliezer 2006;Ji 2013;Li 2010;Stavrakas 2012). The low-quality evidence showed use of amniotic membrane may prevent choroidal detachment (Analysis 3.8.6; RR 0.47, 95% CI 0.13 to 1.71).…”