Efficacy and Safety of Ologen Implant Versus Mitomycin C in Primary Trabeculectomy

Ji, Qingshan; Qi, Bing Bing; Guo, Xiaoling; Zhong, Jingxiang

doi:10.1097/ijg.0000000000000147

Cited by 27 publications

(24 citation statements)

References 26 publications

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“…Ologen implants were associated with lower but nonsignificant percentage reductions in IOP. There was also no significant difference in the reduction of glaucoma medications, success rates, and incidence of complications [10] .…”

Section: Discussionmentioning

confidence: 89%

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Trabeculectomy with Ologen versus Mitomycin C in Juvenile Open-Angle Glaucoma: A 1-Year Study

El-Sayyad¹,

El-Saied²,

Abdelhakim³

2017

Ophthalmic Res

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Background: We assessed bleb morphology and the intraocular pressure (IOP)-lowering effect of trabeculectomy with ologen compared to mitomycin C (MMC) in juvenile open-angle glaucoma (JOAG). Methods: This is a prospective interventional comparative study conducted on 40 eyes (20 patients) with medically uncontrolled JOAG, randomly operating one eye for trabeculectomy with ologen (group A: 20 eyes) and the other with MMC (group B: 20 eyes). IOP measurement, SITA standard perimetry, and spectral domain optical coherence tomography (OCT) for retinal nerve fiber layer (RNFL) thickness were all done pre- and postoperatively. Postoperative blebs were assessed clinically using the Moorfields bleb grading system (MBGS) and anterior segment OCT (AS-OCT). All patients were examined for up to 1 year postoperatively. Results: The mean postoperative IOP was statistically significantly lower than the mean preoperative IOP at each follow-up in each group. At 1 year, the mean postoperative IOP was significantly lower in group A. According to the MBGS, blebs with an ologen implant showed significantly better scoring than those with MMC. AS-OCT showed that ologen-induced blebs had significantly more fluid-filled spaces, cleavage planes, and less fibrosis. Conclusion: Ologen resulted in a lower long-term postoperative IOP, a better bleb morphology, and fewer complications. Our results suggest that ologen may be a useful alternative to MMC in JOAG.

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Section: Discussionmentioning

confidence: 89%

“…In 2015, Ji et al [10] conducted randomized clinical trials on trabeculectomy with an ologen implant compared to trabeculectomy with MMC for the treatment of glaucoma. Ologen implants were associated with lower but nonsignificant percentage reductions in IOP.…”

Section: Discussionmentioning

confidence: 99%

Trabeculectomy with Ologen versus Mitomycin C in Juvenile Open-Angle Glaucoma: A 1-Year Study

El-Sayyad¹,

El-Saied²,

Abdelhakim³

2017

Ophthalmic Res

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“…One encompasses 224 participants in 6 clinical trials [19] and the other 227 eyes in 7 clinical trials [9]. Both disclosed no significant differences in outcomes; however, the authors of the latter study cautioned that the evidence is limited and stated additional randomized controlled trials are needed.…”

Section: Discussionmentioning

confidence: 99%

Collagen matrix vs mitomycin-C in trabeculectomy and combined phacoemulsification and trabeculectomy: a randomized controlled trial

et al. 2016

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BackgroundAntifibrotic agents are commonly utilized to enhance the success rates of trabeculectomy. Novel approaches to further improve success rates and reduce the risks of complications are needed. The purpose of this study was to compare intraocular pressure (IOP)-lowering efficacy and safety of trabeculectomy or combined phacoemulsification and trabeculectomy with mitomycin-C (MMC) vs. Collagen Matrix (CM).MethodsA prospective, multicenter, randomized controlled trial was performed. Ninety-five eyes of 94 patients with uncontrolled glaucoma despite medical therapy, without previous incisional glaucoma surgery underwent trabeculectomy (85 eyes) or combined phacoemulsification and trabeculectomy (10 eyes) and were randomized to MMC or CM. One eye of each subject was analyzed. Patients were followed for 24 months. The criteria for complete success were IOP >5 and ≤21 mmHg with at least a 20% reduction below medicated baseline without additional glaucoma surgery or medications. The main outcome measures were complete success rates at 24 months with Kaplan-Meier analysis and incidence of adverse events.ResultsThe baseline IOPs were 20.4 ± 6.0 mmHg and 21.2 ± 6.1 (mean ± standard deviation, p = 0.49) on 3.2 ± 1.1 and 3.1 ± 1.0 medications (p = 0.53) compared to 11.8 ± 5.2 and 12.8 ± 3.7 (p = 0.36) on 0.5 ± 0.8 and 0.6 ± 1.0 medications (p = 0.63) at 2 years in the MMC and CM groups, respectively. Kaplan-Meier analysis demonstrated complete success rates were similar in both groups at 24 months: 38.4 ± 7.6% with MMC and 56.2 ± 7.9% with CM (mean ± standard error, p = 0.112, log rank test); however, a significantly higher incidence of failure due to persistent hypotony was observed with MMC (p = 0.002).ConclusionsUse of the CM implant at the time of trabeculectomy or combined phacoemulsification and trabeculectomy is associated with similar complete success rates compared to adjunctive MMC; however, the risk of persistent hypotony is higher with MMC.Trial registrationClinicalTrials.gov registration number NCT01440751.Registered 9/14/11Electronic supplementary materialThe online version of this article (doi:10.1186/s12886-016-0393-z) contains supplementary material, which is available to authorized users.

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“…There was no significant difference in the reduction in glaucoma medications, success rate, and incidence of complications. 17 Also, Dada et al 18 evaluated the outcomes of trabeculectomy with use of a subconjunctival Ologen combined with MMC in 33 eyes with primary open angle glaucoma. They declared that it appears to offer encouraging short-term results for IOP control.…”

Section: Discussionmentioning

confidence: 99%

Trabeculectomy with ologen in secondary glaucomas following failed trabeculectomy with MMC: comparative study

El-Saied¹,

Abdelhakim²

2016

Eye

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Efficacy and Safety of Ologen Implant Versus Mitomycin C in Primary Trabeculectomy

Abstract: Trabeculectomy with an Ologen implant is comparable to the use of MMC with a similar long-term success rate. However, it does not seem to offer significant advantages of avoiding the potential complications related to MMC.

Cited by 27 publications

References 26 publications

Trabeculectomy with Ologen versus Mitomycin C in Juvenile Open-Angle Glaucoma: A 1-Year Study

Trabeculectomy with Ologen versus Mitomycin C in Juvenile Open-Angle Glaucoma: A 1-Year Study

Collagen matrix vs mitomycin-C in trabeculectomy and combined phacoemulsification and trabeculectomy: a randomized controlled trial

Trabeculectomy with ologen in secondary glaucomas following failed trabeculectomy with MMC: comparative study

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