ORIGINAL RESEARCH ARTICLE disease, conjunctivitis, and keratitis (3). Ocular surface disease is frequently observed in glaucoma patients and is thought to be the consequence of the chronic use of IOP-lowering eyedrops (4, 5). As a comorbidity of glaucoma, OSD has been held responsible for poor treatment adherence (6) and worsening of patient quality of life (6, 7). In treated glaucoma patients, abnormal tear film function has been detected using objective tests such as fluorescein corneal staining, tear film breakup time (TBUT), osmolarity, or meibomian gland score, although the severity of symptoms varies widely among studies (8-11). Both OSD and glaucoma are age-related diseases (7, 12), though individuals with glaucoma show a higher prevalence of OSD than do those without glaucoma (13). There is increasing evidence to suggest that the preservatives used in antiglaucoma medications may worsen the signs and symptoms of OSD. Benzalkonium chloride (BAK) is one of the first preservatives introduced and is currently the most widely used ophthalmic preservative. Several in vitro and animal studies have shown that solutions containing BAK cause corneal neurotoxicity, tear film disruption, and trabecular meshwork damage (14, 15). As a less harmful preservative,
Treatment with preserved latanoprost has a direct impact on tear cytokine levels, whereas this effect is not observed upon preservative-free latanoprost instillation.
To determine the efficacy and safety of the Ologen collagen matrix adjunctive to Ahmed valve surgery. A randomized prospective multicentre clinical trial involving 58 patients that were followed for one year. Conventional surgery with Ahmed valve was performed in 31 eyes (Control group/CG) and in 27 Ologen (Ologen group/OG) was placed over the valve’s plate. Baseline data: age, corneal thickness, intraocular pressure(IOP) and antiglaucoma medications.Postoperative data (days 1, 7 and months 1, 3, 6 and 12): IOP, antiglaucoma medications, visual acuity and complications were recorded. Frequency of hypertensive phase, complete and qualified success and survival rate were studied. No differences were found between CG and OG in the baseline data. The only difference between groups was a significantly lower IOP at day 1. No other differences were found in the follow-up between groups. Hypertensive phase (56%CG and 55%OG, p = 0,947), complete success 28,6%CG and 30,4%OG (p = 0,88) and qualified success 96,4% and 95,9%(p = 0,794). Survival rates at 1 year were 76,7%(CG) and 69,2%(OG)(p = 0,531). 38,7% of patients in the CG suffered some complication during follow-up and 61,5% in OG(p = 0,086). Ologen does not increase safety or efficacy in Ahmed valve surgery at one-year follow-up. This is the first study that shows no benefit of Ologen adjunctive to this surgery.
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