Trabeculectomy with Combined Use of Subconjunctival Collagen Implant and Low-dose Mitomycin C

Purpose: To evaluate outcomes of trabeculectomy with use of a subconjunctival biodegradable collagen implant (Ologen) combined with mitomycin C (MMC).

Methods: This retrospective study included 33 eyes of 24 patients with primary open-angle glaucoma who underwent fornix-based trabeculectomy with subconjunctival Ologen implant and MMC (0.1 mg/mL×1 min) between October 2008 and April 2010. Data pertaining to the preoperative parameters and postoperative outcomes were recorded. Each patient was followed up for at least 12 months.

Results: The mean age of the study participants was 53.03±7.08 years. Mean preoperative intraocular pressure (IOP) was 34.06±6.56 mm Hg, and decreased to 11.87±2.23 mm Hg, 12.27±2.05 mm Hg, and 12.54±1.67 mm Hg at 3, 6, and 12 months, respectively. Mean postoperative IOP readings at all follow-up visits were significantly lower than those at preoperative levels (P<0.001). Two eyes required ocular hypotensive medications to lower the IOP in the postoperative period. All eyes had a diffuse elevated well-formed bleb, with the implant being visible for 6 to 9 months. Two eyes had a shallow anterior chamber with hypotony during the early postoperative period due to wound leak, whereas 1 case developed implant exposure at 1-week follow-up; all these cases were managed by conjunctival resuturing. Two cases developed a Tenon cyst at 8 to 12 weeks and required needling for restoration of bleb function.

Conclusions: Trabeculectomy with implantation of an Ologen implant and use of low-dose MMC appears to offer encouraging short-term results for IOP control in eyes with primary open-angle glaucoma.