Outcomes of Trabeculectomy Augmented With Subconjunctival and Subscleral Ologen Implantation in Primary Advanced Glaucoma

Angmo, Dewang; Wadhwani, Meenakshi; Upadhyay, Ashish; Temkar, Shreyas; Dada, Tanuj

doi:10.1097/ijg.0000000000000537

Cited by 21 publications

(15 citation statements)

References 22 publications

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“…Angmo et al [16] studied the efficacy and safety of trabeculectomy with a combined subconjunctival and subscleral ologen implant along with a low dose of MMC in eyes with advanced glaucomatous optic neuropathy. They concluded that this approach offered encouraging results in achieving a low target IOP [16] .…”

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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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: 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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“…[9] further evaluated the efficacy and safety of trabeculectomy with combined subconjunctival and subscleral Ologen implant in 27 eyes with advanced glaucomatous optic neuropathy with mean preoperative IOP of 38.3 ± 6.6 mmHg. The short-term results were encouraging with postoperative IOP of 12.5 ± 1.6 mmHg at 24 months.…”

Section: Trabeculectomy Augmented With Biodegradable Implantsmentioning

confidence: 99%

Innovations in glaucoma surgery from Dr. Rajendra Prasad Centre for Ophthalmic Sciences

Dada

Midha

Shah

et al. 2017

Indian J Ophthalmol

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Trabeculectomy surgery is the current standard of care in glaucoma for achieving a low target intraocular pressure if medical therapy is not adequate. Augmentation of trabeculectomy with antimetabolites brought a revolutionary change in the long-term success rates of trabeculectomy, but along with it came a plethora of complications. There still is a big window for therapeutic innovations on this subject. The foremost target for these innovations is to modulate the wound healing response after glaucoma drainage surgery. Achieving the desired balance between long-term success of filtering blebs versus early failure due to scarring of blebs and hypotony due to dysfunctional filtering blebs poses a unique challenge to the ophthalmologists. Alternatives to trabeculectomy such as glaucoma drainage devices and minimally invasive glaucoma surgeries cannot solve the problem of glaucoma blindness in our country, mainly due to their unpredictable results and unfavorable cost-benefit ratio. In this article, we present a summary of our innovations in glaucoma surgery to advance patient care by making it more effective, safer, and economical.

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“…Angmo et al 32 reported a case series of 27 trabeculec-tomies with low-dose MMC (0.1 mg/mL for 1 minute) plus modified Ologen in both subscleral (1 × 1 mm) and subconjunctival (5 mm in diameter) placement for advanced glaucomatous eyes. The study found significant and persistent IOP reduction with this modified Ologen technique (38.3 ± 6.6 mm Hg preoperatively vs 12.3 ± 1.6 mm Hg at 18 months and 12.5 ± 1.6 mm Hg at 24 months postoperatively, p < 0.0001).…”

Section: Adjunct Tools For Conventional Glaucoma Surgerymentioning

confidence: 99%

Improving Glaucoma Surgical Outcomes with Adjunct Tools

Hall

2018

Journal of Current Glaucoma Practice

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Conventional glaucoma surgeries, such as trabeculectomy and glaucoma drainage device (GDD) surgery, have been enhanced by surgeons to improve outcome and decrease complications. Over the last two decades, adjuncts, such as collagen matrix implants, fibrin adhesives, and amniotic membrane transplantation (AMT) have been found to be effective in modulating fibrosis and scarring during the wound-healing process, reducing postoperative inflammation, and repairing bleb leakage or conjunctival erosion. The use of these tools provides several advantages when used in trabeculectomy, GDD surgery, and surface reconstruction associated with glaucoma surgery complications. Their use will be discussed in this review.How to cite this article: Lu LJ, Hall L, Liu J. Improving Glaucoma Surgical Outcomes with Adjunct Tools. J Curr Glaucoma Pract 2018;12(1):19-28.

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Outcomes of Trabeculectomy Augmented With Subconjunctival and Subscleral Ologen Implantation in Primary Advanced Glaucoma

Abstract: Trabeculectomy with low dose Mitomycin-C and with implantation of ologen both subsclerally and subconjunctivally, appears to offer encouraging results in achieving a low target IOP in eyes with advanced primary adult glaucoma.

Cited by 21 publications

References 22 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

Innovations in glaucoma surgery from Dr. Rajendra Prasad Centre for Ophthalmic Sciences

Improving Glaucoma Surgical Outcomes with Adjunct Tools

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