Trabeculectomy Combined With Biological Amniotic Membrane And Healaflow Clinical Effect Of Primary Angle-closure Glaucoma After Oparation

Objective: Although trabeculectomy is still the classic glaucoma surgery method,anti-scarring of postoperative filter passage is still a key issue to be urgently solved by ophthalmologist,for which many scholars are still exploring.On the basis of learning from the existing theoretical results of anti-scarring after glaucoma surgery at home and abroad,this topic further tests a variety of adjustment techniques.To observe the trabeculectomy combined biological amniotic membrane with each time node Healaflow treatment of primary angle-closure glaucoma after operation of visual acuity,intraocular pressure,anterior chamber,filtering bleb and complications such as indicators,discusses the application of combined biological amniotic membrane and Healaflow in trabeculectomy in clinical efficacy and safety of for glaucoma patients to provide the best treatment effect and train of thought.Methods: The cases were collected,randomly grouped and observed.A total of 90 patients diagnosed with primary angleclosure glaucoma in the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from January 2020 to December 2021 were collected according to the inclusion and exclusion criteria.All patients and their families signed informed consent for surgery and consent for special drug use.The 90 patients were randomly divided into control group(single trabeculectomy group)45 cases(45eyes)and observation group(trabeculectomy combined biological amniotic membrane and Healaflow)45 cases(45 eyes),compare two groups of patients with postoperative 1 week,1 month,3 months,6months the visual acuity,intraocular pressure,anterior chamber,filtering bleb and postoperative complications such as indicators,The efficacy of the two groups was evaluated based on all postoperative indicators and statistically analyzed.Results: During the follow-up observation period 6 months after operation,39 eyes of the biamniotic membrane and Healaflow group were effective,with a total effective rate of 88.6%,of which 36 eyes(81.8%)were effective,and 3 eyes(6.8%)were effective.In the control group,30 eyes were effective,the total effective rate was 70%,25 eyes(58.1%)were effective,and 5 eyes(11.6%)were effective.The total effective rate of 6 months follow-up was compared between the two groups,and the difference was statistically significant(P<0.05).The effective rate of biological amniotic membrane and Healaflow group was higher than that of control group.There was no significant difference in the best corrected visual acuity at each time point after surgery between the two groups and the best corrected visual acuity at each time point after surgery between the two groups(P>0.05).The intraocular pressure at each time point after surgery was significantly lower than that before surgery in both groups(P<0.05).There was no significant difference in intraocular pressure between the two groups at 1 week after surgery(P>0.05).The i OP of 1,3 and 6 months after surgery was compared between the two groups,and the difference was statistically significant(P<0.05).The average i OP of the biamniotic membrane and Healaflow groups was lower than that of the control group.There was no obvious exudate or aqueous flash in the anterior chamber and aqueous fluid between the two groups after operation,and the difference was not statistically significant(P>0.05).Functional follicles were compared between the two groups at each time point after surgery,and there was no statistical significance between the two groups1 week after surgery(P>0.05).There were statistically significant differences in follicles between the two groups at 1,3 and 6 months after surgery(P<0.05).Functional follicles in the biamniotic membrane and Healaflow groups were significantly more than those in the control group.The postoperative complications at each time point were compared between the two groups,and the differences were statistically significant(P<0.05).Complications such as conjunctival congestion and sore eyes in the control group were compared with those in the observation group.Intraoperative anterior chamber bleeding occurred in 0 eye of biamniotic membrane group and Healaflow group,and in 2 eyes of control group.Intraatrial hyaluronate was used for hemostasis,and blood was absorbed spontaneously within 4 days after surgery.After surgery,1 eye of the biological amniotic membrane group and Healaflow group and 6 eyes of the control group had shallow anterior chamber.The patients were treated with alternate pupil dilation of atropine and metol,local application of hormone,ear point pressing,cold compress,ultrasonic atomization of houttuynia eye drops and mannitol intravenous drip.Postoperative biamniotic membrane and Healaflow group 1 eyes,2 eyes of the control group showed hypoiop,which was recovered after corresponding treatment.After operation,0 eyes of biamniotic membrane and Healaflow group and 3 eyes of control group showed filtration bubble leakage.No serious complications such as malignant glaucoma and choroid detachment occurred in both groups.These results indicated that both surgical treatment methods can effectively improve i OP,anterior chamber,filter bubble and complications of primary angle-closure glaucoma(PACG).After surgical treatment,the changes of intraocular pressure,anterior chamber,filter bubbles and postoperative complications in the control group and the observation group at each time point after treatment and before treatment can be seen.In the observation group,i OP tended to be stable,most of the anterior chambers formed normal anterior chambers,and the vast majority of patients could form functional follicles,with fewer postoperative complications.The overall efficacy of i OP and other indicators in the observation group was better than that in the control group(P<0.05).Conclusions: 1.Trabeculectomy combined with biological amniotic membrane and Healaflow is effective and safe in clinical application of PACG,and the therapeutic effect is better than single trabeculectomy;2.Clinical biological amniotic membrane can reduce scarring of the filter passage,have anti-value-added effect and reduce surgical complications;Healaflow can reduce inflammation in the process of postoperative wound healing,play the role of anti-filtration blister scar,so as to maintain functional filtration blister,and effectively stabilize i OP;3.Intraoperative Healaflow implantation is easy to operate,does not increase the complexity and difficulty of surgical operation,and does not increase the surgical trauma of patients.It is safe and effective and worthy of clinical application.