Abstract:AIM: To observe the clinical effects of trabeculectomy with incision of “W” form and adjustment suture for primary angle-closure glaucoma(PACG).
METHODS: In a prospective randomized sample controlled clinical study, 48 patients(48 eyes)were randomly divided into two groups:(group A)trabeculectomy with incision of “W” form and adjustment suture;(group B)traditional compound trabeculectomy surgery. The vision, intraocular pressure, astigmatism, ocular surface disease index(OSDI), tear film function, filtering bleb, success rate of operation and postoperative complications were performed at 1 week, 3 months and 6 months postoperatively.
RESULTS:There were no significant difference for corneal astigmatism, OSDI and tear film function between two groups preoperatively( tastigmatism=0.764,tOSDI=0.652,tbreak up time =-1.837, ttear river altitude =-1.535, tST=-1.821, tFL=1.916,P>0.05). There were no statistically significance for OSDI, break up time(BUT), Schirmer test(ST), tear river altitude and fluorescein staining(FL)at 1 week post-operation in group A compared with the fellow eyes(tAOSDI =1.052, tABUT=0.974, tAtear river altitude =0.998, tAST =-1.225, tAFL =0.784, P>0.05), whereas statistically significance at 1 week post-operation in group B compared with the fellow eyes(tBOSDI =14.538,tBBUT=5.241, tBtear river altitude =2.694, tBST =-3.189, tBFL =-1.355,P<0.05). There were no statistically significance for symptom eyes, OSDI, BUT and FL at 2 weeks post-operation in both groups compared with the fellow eyes(tAOSDI =0.828,tABUT=0.537, tAtear river altitude =0.662, tAST = -0.691, tAFL =0.046; tBOSDI =0.774,tBBUT=1.082, tB tear river altitude=0.629, tBST =-0.558, tBFL =-0.719, P>0.05). There were statistically significance for surgically induced astigmatism, filtering bleb in both groups(t astigmatism=9.964, χ2 filtering bleb=9.662,P<0.05), whereas no statistically significance on vision, intraocular pressure, cumulative survival rate of functional filter blebs and success rate of operation in both groups(P>0.05).
CONCLUSIONS: Trabeculectomy with incision of “W” form and adjustment suture is a more favorable solution for primary angle-closure glaucoma patients, which can stabilize the tear film,mitigate the symptom of ocular surface and corneal astigmatism, and therefore improve the visual quality.
