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Year : 2013  |  Volume : 106  |  Issue : 3  |  Page : 188-193

Trabeculectomy assisted by collagen matrix implant (Ologen) in primary congenital glaucoma

Department of Ophthalmology, Ain Shams University, Cairo, Egypt

Correspondence Address:
Momen M Hamdi
Ophthalmology Department, Ain Shams University, 11566 Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2090-0686.127398

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Purpose The primary objective of the study was to evaluate the efficacy and safety of collagen matrix (CM) Ologen in subscleral trabeculectomy (SST) for the treatment of primary congenital glaucoma (PCG). Patients and methods Three children with PCG were operated upon with SST assisted by Ologen. The CM was inserted over the scleral flap under the fornix-based conjunctival flap. Tight closure of the conjunctiva was performed. The first child was a 3-year-old boy with left PCG not operated upon, with intraocular pressure (IOP) of 45 mmHg. The second infant was 7 months old with left recurrent PCG after failed SST with antifibrotic agent mitomycin-C followed by needling performed twice; IOP was 30 mmHg under medications. The third child was a 7-year-old girl with right recurrent PCG after SST at the age of 25 days; IOP was 28 mmHg under medications. Follow-up was planned under general anesthesia at 1 week, 1, 3, and 6 months. Parameters used were IOP measurement, corneal diameter, corneal clarity, cup-disc ratio, and state of the bleb. Photographs were taken at different visits to assess the shape, extent, and vascularity of the bleb. The definition of success was as follows: (1) Full success: IOP less than 15 mmHg without medications; clear cornea. (2) Satisfactory success: IOP less than 21 mmHg without medications; clear cornea. (3) Poor success: IOP less than 21 mmHg with medications. (4) Failure: IOP more than 21 mmHg. Results SST with Ologen in the first two children was successful, with an IOP of 17 mmHg in the first child (satisfactory success) after 8 months and 11 mmHg in the second child (full success) after 6 months. Corneal clarity improved and its diameter decreased in both cases. In the third child, the result was 'poor success' with an IOP of 15 mmHg under one medication at 6-months follow-up. Conclusion Biodegradable CM (Ologen) can be used in PCG to reduce the surgical risks and complications of SST with mitomycin-C in infants. It is also an easier and safer alternative compared with glaucoma valve implants.

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