Published online Nov 6, 2019. doi: 10.12998/wjcc.v7.i21.3436
Peer-review started: July 16, 2019
First decision: September 9, 2019
Revised: September 27, 2019
Accepted: October 5, 2019
Article in press: October 5, 2019
Published online: November 6, 2019
Trabeculectomy is one of the effective surgical techniques for glaucoma, which creates a new drainage channel, resulting in the formation of a subconjunctival bleb. Scarring of the bleb site is the main cause of the failure of the filter. Use of antiproliferative drugs has improved the success rate of the filtration surgery, but they also increase the risk of severe side effects. In our study, we established that the Modified Cortex Mori Capsules (MCMC) have a propensity to increase functional filtering bleb formation and enhance surgical success rate after glaucoma filtering surgery.
To find an effective method to inhibit scar tissue formation at the filtering surgery surgical site. According to the theory of traditional Chinese medicine (TCM), the scar formation after glaucoma filtering surgery mostly belongs to Phlegm-heat. The pharmaceutical composition of MCMC is based on the concept of TCM and can treat both the symptoms and the causes of the glaucoma. In this study, we evaluated the clinical effects of MCMC in prevention of scarring of the filtering bleb after trabeculectomy.
Our aim was to examine the clinical effects by using MCMC (Chinese name: Jiawei Sangbaipi Capsules) in the success rate of functional filtering blebs after filtering surgery.
This study was a prospective clinical randomized controlled study. The enrollment of patients was in strict accordance with inclusion and exclusion criteria. Sixty postoperative patients were randomly divided into two groups: 30 patients in the surgery and placebo group and 30 patients in the surgery and MCMC group. Patients took the placebo or the MCMC 2 wk before and after surgery. Categorical variables and continuous variables were analyzed.
The percentage of functional filtering blebs in MCMC group was 84% at 6 mo after surgery, which was significantly higher than placebo group. The surgical success rate in the MCMC group and the placebo group were 79% ± 8.3% and 57% ± 10.6%, respectively (P < 0.05); Other indicators of the two groups had no significant differences. MCMC not only reduced excessive scar formation and increased success rate of functional filtering blebs but also improved the success of glaucoma filtration operations.
In this study, we observed that MCMC can significantly improve functional filtering bleb formation, increase success rate of the surgery and decrease local inflammation. The mechanisms of MCMC in improving the functional filtering blebs after reclinical glaucoma filtering surgery require further investigation.
Surgery is one of the most effective methods to treat glaucoma. The reasons that cause the failure of the surgery are very complicated. The theory of TCM recognizes glaucomatous postoperative signs differently than western medicine. TCM provides a new choice to improve the success rate of glaucoma filtering surgery. The efficacy of MCMC still needs large clinical trials and long-term observations as well as in vitro experiments.