Biodegradable Collagen Implants in Trabeculectomy

Ichhpujani, Parul; Dada, Tanuj; Bhartiya, Shibal

doi:10.5005/jp-journals-10008-1179

Cited by 8 publications

(5 citation statements)

References 26 publications

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“…On histologic examination, a prominent bleb was observed in the collagen matrix implanted bleb. 24 However, biodegradation occurred slower than the previously mentioned 60-90 days period. Even after six months post-filtration surgery, partial passive and enzymatic biodegradation of the implant was still evident in the collagen group.…”

Section: Discussionmentioning

confidence: 88%

Trabeculectomy with collagen implant for the treatment of glaucoma

Kadir,

Maurya,

Noman

et al. 2023

IJCEO

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The goal is to assess the effectiveness and safety of trabeculectomy with collagen implants for glaucoma patients who cannot be managed medically. This research is a case series that intervenes without randomization and focuses on potential outcomes. The study consisted of 76 treated eyes of 76 patients with uncontrollable glaucoma. A thorough examination of the eyes was performed on all patients, and the results were documented. Each patient underwent conventional trabeculectomy surgery using the fornix-based approach. Additionally, a subconjunctival collagen implant known as Ologen was also utilized. We recorded preoperative data such as age, gender, best-corrected visual acuity, intraocular pressure, glaucoma type, and a few preoperative antiglaucoma medications. We recorded the intraocular pressure after surgery, the number of glaucoma medications given after surgery, and any complications that occurred during the postoperative period. Each patient was monitored for a minimum of six months. Before the operation, the average intraocular pressure (IOP) was 34.21 ± 12.5, and the patient took at least two IOP-lowering medications (average 2.3). The postoperative IOP was measured after three months and found to be 13.85±5.42mm Hg, with a p-value of 0.060. On average, the blood pressure decreased by 16.42±6.42 mmHg after six months, with a p-value of 0.056. After six months, it was observed that the medication significantly reduced 1.22 in intraocular pressure (P=<0.001), leading to a notable decrease of 17.79 mmHg. The success rate stood at a commendable 97.36% at the three-month mark, but it reduced to an alarming 88.15% by the last visit. Within just one month after the operation, several complications arose, including three cases of hyphaema, one case of the shallow anterior chamber, and two cases of wound leak. All patients showed gradual improvement with conservative management. However, three of them developed cataracts within three months. For patients who have not responded to topical antiglaucoma medications, to manage intraocular pressure is a dependable and safe surgical procedure that offers an efficient treatment option.

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Section: Discussionmentioning

confidence: 88%

Trabeculectomy with collagen implant for the treatment of glaucoma

Kadir,

Maurya,

Noman

et al. 2023

IJCEO

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“…None of the patients in our study developed any Ologen specific side effects like allergy, translocation or expulsion of the implant, as reported by other authors. [ 13 23 24 ]…”

Section: Discussionmentioning

confidence: 99%

Comparison of bleb morphology by anterior segment optical coherence tomography and clinical outcome after phacotrabeculectomy with mitomycin C or Ologen implant

Chelerkar

Agrawal

Kalyani

et al. 2021

Indian Journal of Ophthalmology

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Purpose: To compare the bleb morphology by Anterior Segment Optical Coherence Tomography (ASOCT) and clinical outcome after Phacotrabeculectomy with either mitomycin C or Ologen implant. Methods: In a prospective interventional active controlled study, 93 patients aged 18 years and above underwent phacotrabeculectomy with either mitomycin C (53 eyes) or ologen implant (40 eyes), followed up for 12 months. The primary outcome measure was to note the evolution of bleb morphology by ASOCT in the two groups over 12 months. Secondary outcome measures were mean IOP, reduction in the need for anti-glaucoma medications, and complications seen in the two groups. Results: All parameters in the two groups were comparable preoperatively ( P >0.05). Best corrected visual acuity at 12 months was 0.38±0.27 in mitomycin group and 0.31±0.23 in ologen group ( P =0.151). Post-operative IOP at 12 months was 14.09±3.1mmHg (95%CI 13.22-14.97) in mitomycin group, and 13.25±2.5 mmHg (95%CI 12.40-14.30) in ologen group ( P =0.254).The mean number of medications was 0.36±0.68 in mitomycin group and 0.38+/-0.70 in ologen group at 12 months ( P =0.91). Overall success was achieved in 98.1 % of patients in mitomycin group and 90 % of patients in ologen group at 12 months. No major sight-threatening complications were noted in any group. AS-OCT imaging at 12 months showed multiform reflectivity with multiple large cystic spaces in both groups, with good IOP control. Conclusion: Phacotrabeculectomy using Mitomycin C and Ologen implant resulted in similar morphologic and functioning blebs at one year with comparable efficacy in controlling intraocular pressure.

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“…Currently, two types of Ologen are used in glaucoma surgery, 12 mm in diameter with 1 mm of thickness and 6 mm in diameter with 2 mm of thickness. [ 15 16 ]…”

Section: Methodsmentioning

confidence: 99%

Comparison between Ologen implant and different concentrations of Mitomycin C as an adjuvant to trabeculectomy surgery

et al. 2017

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CONTEXT:Trabeculectomy is the most common surgical procedure for treatment of glaucoma. To improve success rates, adjuvants were utilized as Mitomycin C (MMC) and Ologen implant.AIMS:This study aims to establish efficacy and safety of Ologen implant versus MMC in trabeculectomy.SETTING AND DESIGN:A prospective, comparative clinical study was conducted at the Department of Ophthalmology, Assiut University, between December 2014 and April 2016.SUBJECTS AND METHODS:Patients with primary open-angle glaucoma (OAG), primary narrow-angle glaucoma and secondary OAG were assigned equally to trabeculectomy with Ologen, 0.4 mg/mL or 0.2 mg/mL MMC. The study outcome measures were reduction in intra-ocular pressure (IOP), success rates, survival analysis, and rate of complications.STATISTICAL ANALYSIS USED:SPSS software Version 17.0 (SPSS, Inc., IL, USA) was utilized.RESULTS:Thirty eyes were included in the study. Mean baseline IOP in Ologen, MMC 0.4 and MMC 0.2 groups were 27.43 ± 2.97, 28.4 ± 3.24, and 27.56 ± 2.69 mmHg, respectively. At week 24 follow-up, mean IOP in Ologen, MMC 0.4 and MMC 0.2 groups were 18.55 ± 3.18, 16.2 ± 3.22, and 16.93 ± 3.04 mmHg, respectively. No significant inter-group difference was noticed at any visits. Complete success was achieved in 10%, 40%, and 30%, whereas incomplete success in 70%, 50%, and 60%, respectively in Ologen, MMC 0.4 and MMC 0.2 groups. No treatment group difference was reported by Kaplan–Meier analysis. Shallow anterior chamber occurred more in Ologen and MMC 0.4 groups. A single case of serous choroidal effusion had occurred in MMC 0.4 group.CONCLUSION:Ologen implant is a promising alternative to MMC for improving the success rate of trabeculectomy.

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Biodegradable Collagen Implants in Trabeculectomy

Cited by 8 publications

References 26 publications

Trabeculectomy with collagen implant for the treatment of glaucoma

Trabeculectomy with collagen implant for the treatment of glaucoma

Comparison of bleb morphology by anterior segment optical coherence tomography and clinical outcome after phacotrabeculectomy with mitomycin C or Ologen implant

Comparison between Ologen implant and different concentrations of Mitomycin C as an adjuvant to trabeculectomy surgery

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