Trabeculectomy with combined use of subconjunctival collagen implant and low-dose mitomycin C.
OBJECTIVE
To evaluate outcomes of trabeculectomy with use of a subconjunctival biodegradable collagen implant (Ologen) combined with mitomycin C (MMC).


METHODS
This retrospective study included 33 eyes of 24 patients with primary open-angle glaucoma who underwent fornix-based trabeculectomy with subconjunctival Ologen implant and MMC (0.1 mg/mL×1 min) between October 2008 and April 2010. Data pertaining to the preoperative parameters and postoperative outcomes were recorded. Each patient was followed up for at least 12 months.


RESULTS
The mean age of the study participants was 53.03±7.08 years. Mean preoperative intraocular pressure (IOP) was 34.06±6.56 mm Hg, and decreased to 11.87±2.23 mm Hg, 12.27±2.05 mm Hg, and 12.54±1.67 mm Hg at 3, 6, and 12 months, respectively. Mean postoperative IOP readings at all follow-up visits were significantly lower than those at preoperative levels (P<0.001). Two eyes required ocular hypotensive medications to lower the IOP in the postoperative period. All eyes had a diffuse elevated well-formed bleb, with the implant being visible for 6 to 9 months. Two eyes had a shallow anterior chamber with hypotony during the early postoperative period due to wound leak, whereas 1 case developed implant exposure at 1-week follow-up; all these cases were managed by conjunctival resuturing. Two cases developed a Tenon cyst at 8 to 12 weeks and required needling for restoration of bleb function.


CONCLUSIONS
Trabeculectomy with implantation of an Ologen implant and use of low-dose MMC appears to offer encouraging short-term results for IOP control in eyes with primary open-angle glaucoma.
*Glaucoma Facility, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India †Vision Eye Institute, Chatswood, Australia.
Tanuj
T
Dada
Rakhi
R
Kusumesh
Shveta Jindal
SJ
Bali
Sourabh
S
Sharma
Amit
A
Sobti
Vishal
V
Arora
Anita
A
Panda
D020341:Absorbable Implants; D000477:Alkylating Agents / Q000008:administration & dosage*; D003094:Collagen / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006025:Glycosaminoglycans / Q000627:therapeutic use*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome
D000477:Alkylating Agents; D006025:Glycosaminoglycans; C058506:collagen-glycosaminoglycan copolymer; D016685:Mitomycin; D003094:Collagen