Trabeculetomy combined with implantation of silicon rubber slice for intractable glaucoma

Objective: To investigate the lowering-pressure outcome and postoperative complications of trabeculectomy with implantation of silicon rubber slice for intractable glaucoma.

Methods: Sixty eyes with intractable glaucoma, including 12 eyes with neovascular glaucoma, 14 eyes with aphakic or pseudophakic glaucoma, 4 eyes with congenital glaucoma, 18 eyes with failed filtering surgery glaucoma and 12 eyes with glaucoma secondary to trauma, were performed trabeculectomy with implantation of silicon rubber slice. The postoperative lowering-pressure outcome and complications also were observed.

Results: All patients were follow-up for 5 to approximately 34 months ( mean, 18.3 months) . The postoperative intraocular pressure of patients was 17.30 to approximately 37.19 mmHg [mean, (23.36 +/- 4.06) mmHg] at the last visit. Of 60 eyes, the postoperative intraocular pressure was below 21 mmHg in 38 eyes (63.3%), between 21 to 30 mmHg in 18 eyes (30%) and higher than 30 mmHg only in 4 eyes (6.7%). No serious complications and rejection related to implantation of silicon rubber slice occurred in this group during the follow-up period.

Conclusions: Trabeculectomy combined with implantation of silicon rubber slice seems to be an ideal procedure for treatment of intractable glaucoma in developing countries, especially in vast country hospital in China, this surgery also can replace the expensive import drainage device implant (Molteno tube implant) therapy for intractable glaucoma.