AIM: To evaluatethe clinical efficacy of trabeculectomy combined with amniotic membrane transplantation for refractory glaucoma.

METHODS: This study included 29 cases(29 eyes)with developmental refractory glaucoma at such high risks as neovascular,uveitis,aphakia, pseudophakic.Trabeculectomy with amniotic membrane transplantation was performed in 13 cases and trabeculectomy without amniotic membrane transplantation in 16 cases. The outcome measurements included postoperative intraocular pressure(IOP), the used quantity of antiglaucoma medications, the morphologic characteristics of the filtering blebs and complications. All patients were followed for 12mo.

RESULTS: Complete success was seen 11/13(84.6%)in study eyes and 10/16(62.5%)in aontrol eyes at 6mo postoperatively(P<0.05), and 10/13(76.9%)in study eyes and 10/16(62.5%)in control eyes at 12mo after surgery, respectively(P<0.05). IOP decreased from 50.3±11.3mmHg and 49.7±10.7mmHg preoperatively in study and control groups to 15.7±1.1mmHg and 19.8±2.3mmHg respectively at 12mo of postoperation(P<0.05). Early postoperative ocular hypotony developed in 3(18.8%)control eyes owing to excessive filtration but none of them in study eyes. Encapsulated bleb occurred in 6(37.5%)control eyes but only in 1(7.7%)study eyes.

CONCLUSION: In refractory glaucoma,trabeculectomy combined with amniotic membrane transplantation compared to trabeculectomy without amniotic membrane transplantation has higher success rates, better control of postoperative IOP, and less complication rates.