Five Years' Outcomes of Trabeculectomy with Cross-linked Sodium Hyaluronate Gel Implantation for Chinese Glaucoma Patients.

Xiao Wang; Wan-wei Dai; Ya-long Dang; Ying Hong; Chun Zhang

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Five Years' Outcomes of Trabeculectomy with Cross-linked Sodium Hyaluronate Gel Implantation for Chinese Glaucoma Patients.

Author: Xiao WANG ^{1
,

2} ; Wan-Wei DAI ^{1
,

2} ; Ya-Long DANG ³ ; Ying HONG ^{1
,

4} ; Chun ZHANG ^{1
,

4}
Author Information

1. Department of Ophthalmology, Peking University Third Hospital
2. Institute of Population Research/World Health Organization Collaborating Center, Peking University, Beijing 100871, China.
3. Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
4. Beijing Key Laboratory for Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China.
Publication Type:Journal Article
Keywords: Cicatrix; Cross-linked Sodium Hyaluronate; Glaucoma; Trabeculectomy
MeSH: Aged; Aged, 80 and over; Female; Follow-Up Studies; Glaucoma; therapy; Humans; Hyaluronic Acid; therapeutic use; Intraocular Pressure; Male; Middle Aged; Prospective Studies; Trabeculectomy; Treatment Outcome
From: Chinese Medical Journal 2018;131(13):1562-1568
CountryChina
Language:English
Abstract:
BackgroundTrabeculectomy is the most efficient surgical treatment. Prevention failure of bleb cicatrix would lead to unsatisfactory postoperative intraocular pressure (IOP) controlling and unsatisfactory success rate. The aim of this study was to evaluate the 5-year outcomes of trabeculectomy with a cross-linked sodium hyaluronate gel implantation for Chinese glaucoma patients.
MethodsThis is a prospective, case-controlled study. Patients who were to be applied first-time trabeculectomy in the Department of Ophthalmology of Peking University Third Hospital between 2010 and 2012 were included in the study. Totally, 60 eyes were randomly assigned to the trabeculectomy group (TA group) or the trabeculectomy with cross-linked sodium hyaluronate gel implantation group (TH group). Follow-up was finished at 1 week, 1 month, 3 months, 1 year, 3 years, and 5 years after the operation. The statistical index of demographic data, IOP, bleb shape, and any complications or medications or surgical procedures were recorded and assessed by SPSS 19.0 software through independent t-test, one-way analysis of variance (ANOVA) and Pearson's Chi-square test, respectively.
ResultsThe baseline IOP was comparable between the two groups (t= -1.00, P= 0.32) while the postoperative IOP was significantly lower in the TH group at 1, 3 and 5 years' time points (P = 0.00, P= 0.01 and P = 0.01, respectively). According to the Indiana Bleb Appearance Grading Scale, the height and extent of bleb were better in the TH group at all follow-up time points (P < 0.05), however, the comparison of bleb vascularity showed no statistical difference (P > 0.05). TA group had a higher percentage of complications (13% vs. 3%) compared to TH group; however, there was no statistical difference in the comparison of each statistical item (P > 0.05, respectively). The complete success at 5 years was higher in the TH group than that in the TA group (78% vs. 54%, P = 0.03).
ConclusionOur results suggested that implantation of cross-linked sodium hyaluronate gel with trabeculectomy was more efficient and would improve the prognosis of glaucoma patients.