Capsule excision and Ologen™ implantation for revision after glaucoma drainage device surgery

Rosentreter, André; Mellein, Anne C.; Konen, Wolfgang; Dietlein, Thomas S.

doi:10.1007/s00417-010-1385-y

Cited by 38 publications

(23 citation statements)

References 16 publications

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“…Ologen only functions as a wound modulator and does not have any antifibrotic properties to counter the scarring response. However,in previous human studies, Ologen implants used along with deep sclerectomy enhanced the success rates when compared to deep sclerectomy [13], [34]. Future randomized, controlled trials should help determine its place in glaucoma surgery.…”

Section: Discussionmentioning

confidence: 98%

“…It is a disc-shaped porcine-derived biodegradable collagen matrix that has been developed to prevent excessive scarring after trabeculectomy [2], [11]. When inserted under the conjunctiva at the time of trabeculectomy, it not only acts as a reservoir but also helps to separate mechanically the conjunctiva and episcleral surface and prevent adhesions between them [12], [13]. Recently, many comparative controlled trials have compared the efficacy and tolerability of trabeculectomy augmented with Ologen versus trabeculectomy plus MMC, but the results are not completely consistent.…”

Section: Introductionmentioning

confidence: 99%

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Ologen Implant versus Mitomycin C for Trabeculectomy: A Systematic Review and Meta-Analysis

Wang

Zhang

et al. 2014

PLoS ONE

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ObjectiveTo evaluate the application of the Ologen implant compared to mitomycin C (MMC) on the outcome of trabeculectomy and to examine the balance of risks and benefits.MethodsA systematic literature search (Pubmed, Embase, the Cochrane Library, and the Chinese Biomedicine Database) was performed. Randomized controlled trials comparing the Ologen implant with MMC in trabeculectomy were selected. The efficacy measures were the weighted mean differences (WMDs) for the intraocular pressure reduction (IOPR), the reduction in glaucoma medications, and the relative risks (RRs) for success rates. The tolerability measures were RRs for adverse events. The pooled effects were calculated using the random-effects model.ResultsSeven randomized controlled trials including 227 eyes were included in this meta-analysis. The WMDs of the IOPR comparing the Ologen group with the MMC group were −2.98 (95% Cl: −5.07 to −0.89) at one month, −1.41 (−3.72 to 0.91) at three months, −1.69 (−3.68 to 0.30) at six months, −1.94 (−3.88 to 0.01) at 12 months, and 0.65 (−2.17 to 0.47) at 24 months. There was no statistically significance except at one and 12 months after surgery. No significant difference in the reduction in glaucoma medications or complete and qualified success rates were found. The rates of adverse events also did not differ significantly between Ologen and MMC.ConclusionsThe Ologen implant is comparable with MMC for trabeculectomy in IOP-lowering efficacy, reduction in the number of glaucoma medications, success rates, and tolerability. However, the results should be interpreted cautiously since relevant evidence is still limited, although it is accumulating. Further large-scale, well-designed randomized controlled trials are urgently needed.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Ologen Implant versus Mitomycin C for Trabeculectomy: A Systematic Review and Meta-Analysis

Wang

Zhang

et al. 2014

PLoS ONE

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“…[1516] They have been used along with deep sclerectomy with better long term success,[1718] and have been used as a spacer following capsule excision after failed GDD surgery. [23]…”

Section: Discussionmentioning

confidence: 99%

Comparison of outcomes of trabeculectomy with mitomycin C vs. ologen implant in primary glaucoma

Senthil

Rao

Jonnadula

et al. 2013

Indian J Ophthalmol

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Purpose:To compare the safety and efficacy of trabeculectomy with Ologen implant vs. trabeculectomy with Mitomycin C (MMC).Materials and Methods:In a prospective, randomized, pilot study, 39 eyes of 33 subjects with medically uncontrolled primary glaucoma, aged 18 years or above underwent trabeculectomy either with MMC (20 eyes) or with Ologen implant (19 eyes). The primary outcome measure was cumulative success probability, defined as complete if the intraocular pressure (IOP) was > 5 and ≤ 21 mm Hg without anti-glaucoma medications or additional surgery and qualified if an IOP was > 5 and ≤ 21 mm Hg with or without anti-glaucoma medications.Results:Mean (± standard deviation) follow-up in Ologen group was 19.1 ± 8.1 months, and in MMC group was 18.0 ± 8.4 months. Mean IOP reduction at 6 months was significantly lower (P = 0.01) in the MMC group (11.9 ± 2.9 mm Hg) as compared to Ologen group (14.6 ± 2.7 mm Hg). However, at 12 months (P = 0.81) and 24 months (P = 0.32), the mean IOP was similar between the 2 groups. Complete success probability at the end of 6 months in Ologen group was 100% (95% confidence interval: 59.1 - 99.0) was similar (P = 0.53) to that in MMC group (93.8%, 95% CI: 63.2 - 99.1). The incidences of early post-operative complications were similar in the 2 groups, except hyphema, which was significantly more in Ologen group (P = 0.02).Conclusion:In this pilot study, the success of trabeculectomy and complications were similar in both Ologen and MMC groups at the end of 6 months.

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“…Analyses with the further advanced CGMs of the second generation (atelocollagen matrices) in revision surgery after failed Baerveldt drainage device surgery revealed supplementary OLO implantation to be a safe method potentially increasing the results in revision surgery of glaucoma drainage devices compared to revision without OLO as a placeholder [22]. Furthermore, two prospective studies using the CGM of the second generation for augmentation of trabeculectomy showed no significant difference compared to the MMC study group (0.2 mg/ml for 2 min) in terms of postoperative success rates [23,24].…”

Section: Discussionmentioning

confidence: 99%

Trabeculectomy Using Mitomycin C versus an Atelocollagen Implant: Clinical Results of a Randomized Trial and Histopathologic Findings

et al. 2013

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Purpose: To assess the efficacy of trabeculectomy with a biodegradable Ologen™ implant (OLO) versus mitomycin C (MMC) in patients in a prospective randomized clinical trial. Methods: In the MMC group (15 patients), trabeculectomy was performed according to standard protocols. In the OLO group (15 patients) after standard trabeculectomy, the implant was positioned on top of the scleral flap, and no MMC was applied. Results: Mean preoperative intraocular pressure (IOP) levels (OLO: 28.0 ± 9.4; MMC: 23.9 ± 5.0 mm Hg; p = 0.21) and medication score (OLO: 3.4 ± 1.6; MMC: 3.6 ± 1.5; p = 0.56) were comparable in both groups. One year after surgery, the mean IOP was 15.9 ± 4.5 mm Hg in the OLO group (p < 0.01, 43% reduction) and 11.0 ± 2.6 mm Hg in the MMC group (p < 0.01, 54% reduction). The surgical success rate 12 months after surgery was 93.3% in the MMC group and 40% in the OLO group (p = 0.01). Conclusions: With the atelocollagen-glycosaminoglycan matrix OLO it was not possible to reach the surgical success rate and pressure reduction achieved in the MMC group.

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Capsule excision and Ologen™ implantation for revision after glaucoma drainage device surgery

Abstract: Although our study has the limitations of small sample size and observational study design, it shows that further investigation is warranted into the potential of Ologen in revision surgery after GDD implantation.

Cited by 38 publications

References 16 publications

Ologen Implant versus Mitomycin C for Trabeculectomy: A Systematic Review and Meta-Analysis

Ologen Implant versus Mitomycin C for Trabeculectomy: A Systematic Review and Meta-Analysis

Comparison of outcomes of trabeculectomy with mitomycin C vs. ologen implant in primary glaucoma

Trabeculectomy Using Mitomycin C versus an Atelocollagen Implant: Clinical Results of a Randomized Trial and Histopathologic Findings

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