Evaluation Of The Efficacy Of Surgery Therapy For Chronic Angle-closure Glaucoma After Laser Peripheral Iridectomy

ObjectiveTo investigate the clinical effect of trabeculectomy and tenonectomy combined with biological amniotic membrane transplantation in the treatment of chronic angle-closure glaucoma after laser peripheral iridectomyMethodsLaser peripheral iridectomy was performed on 49 eyes of 32 cases with chronic angle-closure glaucoma after laser peripheral iridectomy were selected and treated with trabeculectomy and tenonectomy combined with biological amniotic membrane transplantation under scleral flap.The patients were followed up for 6-12 months.The visual activity,intraocular pressure,C/D ratio of optic disc,filter bleb and complications were observed and analyzed on the 1,2weeks,1,3,6,9,12 months after surgery.Results1.The clinical symptomsPreoperative significant eye acid or eye swelling,postoperative one year the symptoms were significantly reduced or disappeared.2.The Intraocular pressure,Visual activity,Drug species,C/D ratioPreoperative intraocular pressure was(25.62±5.95)mmHg(1 mmHg= 0.133 kP),the visual activity was range from 0.06 to 1.0,the drug species were(1.69±0.74),and the C/D ratio was(0.66±0.11).Followed up for 6-12 months,the average IOP at 1 week,2 weeks,1,3,6,9,12 months after surgery was significant different from the preoperative level(P<0.05).At the end of 1 week,the IOP of 49 eyes were(11.63±1.68)mmHg,respectively compared with baseline(25.62±5.95)mmHg,there were statistically significant decrease(P<0.05).Follwed up three months after surgery shows that the IOP was(14.71±2.23)mmHg,those were significant decreased compared with the preoperative level(P<0.05),drug species was(0.31±0.71)decreased significantly,the C/D ratio was no significant different compared with the preoperative level(P>0.05).At the last follow-up,the IOP within normal limits unutilized anti-glaucoma drugs in 30 eyes accounting for 75.00%.The IOP of 8 eyes accounting for 20.00% were controlled after utilized 1 or 2 kinds of anti-glaucoma drugs,the IOP of 2 eyes accounting for 5.00% were controlled after the second anti-glaucoma surgery or cataract surgery.The functional filtering bleb formed in 27 eyes accounting for 67.50%.Preoperative use of a variety of drugs to reduce intraocular pressure,only 1 or 2 kinds of intraocular pressure lowering drugs were used after the operation.Review of the anterior chamber angle without progressive adhesion closure.No postoperative complication occurred after surgery.ConclusionThe combined surgery of ocular tenonectomy,trabeculectomy and amniotic membrane transplantation for the treatment of chronic angle-closure glaucoma after laser peripheral iridectomy may be safe and efficient.