PURPOSE: To assess the surgical outcomes and wound healing reaction of a filtering bleb after trabeculectomy using mitomycin C-soaked biodegradable collagen matrix (ologen). METHODS: Thirty eyes, in which the intraocular pressure (IOP) could not be controlled within the proper range by medication or laser treatment, were targeted in this study. After trabeculectomy with mitomycin C (0.2 mg/mL, 0.1 mL)-soaked ologen, surgical outcomes were assessed by evaluating bleb morphology by the Moorfield bleb grading system, as well as internal reflectivity and wound healing response of the bleb using a slit lamp and ultrasound biomicroscopy. The follow-up period continued for 12 months after surgery. RESULTS: Twelve months after surgery, 12/30 (40.0%) eyes were considered complete successes and 24/30 (80%) eyes as qualified successes. This rate is similar to the rate of our conventional trabeculectomy. The encapsulated bleb was the most frequent complication (9 eyes) and generally occurred at approximately 2 weeks after surgery. No avascular blebs were observed at final follow-up. CONCLUSIONS: Trabeculectomy with mitomycin C-soaked ologen do not seem to exert any synergistic effect with antimetabolites in terms of a reduction in IOP. However, the mitomycin C-soaked collagen matrix implant used in trabeculectomy resulted in comparatively stable IOP and did not aggravate wound healing or scar formation. Encapsulated blebs were generated at a more rapid pace in larger amounts compared with conventional trabeculectomy. The management of encapsulated blebs may be crucial to improving the success rate of surgery.
PURPOSE: To assess the surgical outcomes and wound healing reaction of a filtering bleb after trabeculectomy using mitomycin C-soaked biodegradable collagen matrix (ologen). METHODS: Thirty eyes, in which the intraocular pressure (IOP) could not be controlled within the proper range by medication or laser treatment, were targeted in this study. After trabeculectomy with mitomycin C (0.2 mg/mL, 0.1 mL)-soaked ologen, surgical outcomes were assessed by evaluating bleb morphology by the Moorfield bleb grading system, as well as internal reflectivity and wound healing response of the bleb using a slit lamp and ultrasound biomicroscopy. The follow-up period continued for 12 months after surgery. RESULTS: Twelve months after surgery, 12/30 (40.0%) eyes were considered complete successes and 24/30 (80%) eyes as qualified successes. This rate is similar to the rate of our conventional trabeculectomy. The encapsulated bleb was the most frequent complication (9 eyes) and generally occurred at approximately 2 weeks after surgery. No avascular blebs were observed at final follow-up. CONCLUSIONS: Trabeculectomy with mitomycin C-soaked ologen do not seem to exert any synergistic effect with antimetabolites in terms of a reduction in IOP. However, the mitomycin C-soaked collagen matrix implant used in trabeculectomy resulted in comparatively stable IOP and did not aggravate wound healing or scar formation. Encapsulated blebs were generated at a more rapid pace in larger amounts compared with conventional trabeculectomy. The management of encapsulated blebs may be crucial to improving the success rate of surgery.
Authors: Angelo P Tanna; Alfred W Rademaker; C Gustavo de Moraes; David G Godfrey; Steven R Sarkisian; Steven D Vold; Robert Ritch Journal: BMC Ophthalmol Date: 2016-12-29 Impact factor: 2.209
Authors: Salvatore Cillino; Alessandra Casuccio; Francesco Di Pace; Carlo Cagini; Lucia Lee Ferraro; Giovanni Cillino Journal: BMC Ophthalmol Date: 2016-03-05 Impact factor: 2.209