Ultrasound biomicroscopy and optical coherence tomography imaging of filtering blebs after deep sclerectomy with new collagen implant.
OBJECTIVE
To identify the clinical and anatomic characteristics of filtering blebs after glaucoma surgery with a new biodegradable collagen implant, Ologen, using ultrasound biomicroscopy (UBM) and Visante anterior segment optical coherence tomography (OCT).


METHODS
The authors conducted a prospective interventional case series in 15 eyes with openangleglaucoma. The authors performed limbal-based deep sclerectomy with Ologen implantation in the scleral bed. UBM, Visante anterior segment OCT, and a complete ophthalmic examination were performed at each follow-up visit, at 1 day, and 1, 4, and 12 weeks postoperatively.


RESULTS
Intraocular pressure (IOP) was significantly reduced (p<0.001) from a mean preoperative value of 24.2-/+6.8 mmHg (n=2.82 glaucoma medications) to a mean postoperative value of 8.1-/+1.2 (n=0), 8.5-/+1.3 (n=0), 11.7-/+3.2 (n=0), and 14.2-/+3.9 mmHg (n=0.33) at 1 day, and 1, 4, and 12 weeks, respectively. Lower IOP correlated with bleb height and low trabeculocorneal membrane thickness (r=0.79, p<0.01, r=0.91, p<0.001) based on UBM examination. Lower IOP correlated with thin bleb wall, large subconjunctival fluid spaces, and low bleb tissue reflectivity (r=0.81, p<0.01, p<0.001, and p<0.001) based on OCT examination. No postoperative complications were reported.


CONCLUSIONS
UBM and OCT examinations are useful methods to evaluate outflow mechanisms after glaucoma surgery. Deep sclerectomy with Ologen implantation seems to be an effective and well-tolerated method to reduce IOP.
Aptel
Florent
F
Department of Ophthalmology, Edouard Herriot Hospital, Lyon - France. aptel_florent@hotmail.com
Dumas
Sophie
S
Denis
Philippe
P
D000368:Aged; D001082:Aqueous Humor / Q000502:physiology; D001768:Blister / Q000175:diagnosis* / Q000378:metabolism; D003094:Collagen / Q000627:therapeutic use*; D003228:Conjunctiva / Q000000981:diagnostic imaging / Q000473:pathology*; D003952:Diagnostic Imaging; D004343:Drug Implants; D005260:Female; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006025:Glycosaminoglycans / Q000627:therapeutic use*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D011446:Prospective Studies; D012590:Sclera / Q000601:surgery*; D012599:Sclerostomy; D041623:Tomography, Optical Coherence
D004343:Drug Implants; D006025:Glycosaminoglycans; C058506:collagen-glycosaminoglycan copolymer; D003094:Collagen