Efficacy of Intraoperative Amniotic Membrane versus Mitomycin-C in Trabeculectomy: A Comparitive Randomised Controlled Trial

Introduction: Trabeculectomy, has been the surgery of choice for the management of glaucoma not controlled with medications. Anti-fibrotic agents, such as Mitomycin C(MMC), has become widely accepted to reduce the amount of fibrosis. Amniotic membrane may be an acceptable replacement to MMC; as it can also provide as a space-occupying component. Aims And Objectives: To evaluate the Intraocular pressure(IOP) lowering effect of Trabeculectomy with the use of Amniotic membrane transplant(AMT) compared with the standard Trabeculectomy with Mitomycin-C(MMC) in patients with Primary glaucoma. Materials and Methods: Intraocular pressure lowering effect of Trabeculectomy with the use of Amniotic membrane transplant was compared with the standard Trabeculectomy with Mitomycin-C in patients with Primary glaucoma. It was carried out on the patients attending Glaucoma Department of a tertiary hospital. Results: Comparison of the two groups with respect to IOP at Post Operative Day(POD) 1 and 1 week, showed no difference, but both groups reached a level of target IOPs. At 1 month follow up, mean IOP control in Group A(underwent Trabeculectomy with Amniotic membrane) was 14.72mmhg with SD +/-3.78 and in Group B( Trabeculectomy with MMC) was 17.60mmhg with SD +/-4.65 with a p value of 0.0203 which was statistically significant. But further follow ups at 3 months and 6 months showed no difference in IOP between Group A and Group B and had reached target IOP levels. Conclusion: It was observed that both Amniotic membrane and MMC in trabeculectomy proved to be effective adjuvants and results are comparable with minor modifications to the bleb.