Control of Filtering Bleb Structure through Tissue Bioengineering: An Animal Model

Abstract

Implantation of a biodegradable, porous collagen matrix in the subconjunctival space offers the potential for a new means of avoiding early scar formation and maintaining long-term IOP control by creating a loosely structured filtering bleb.

A prospective randomised trial of trabeculectomy using mitomycin C vs an ologen implant in open angle glaucoma

“…It led to a randomised collagen deposition and microcyst formation after penetrating anti-glaucomatous surgery in contrast to the negative control and decreased early postoperative scarring. 8,9 Moreover, the ologen implant will also be adjuvant in repairing postoperative bleb leaks. 9 In human subjects, the ologen implant was tested for augmentation in deep sclerectomy.…”

“…Moreover, the biodegradable implant decreased early postoperative scarring. 8 A prospective pilot study revealed no significant difference in the postoperative IOP after trabeculectomy in the control group and trabeculectomy with ologen in the study group. 10 In a prospective, randomised study with two interventional groups, we investigated the ologen implant as an alternative for modulation of wound healing in anti-glaucomatous surgery.…”

“…The scleral flap was then repositioned and fixed with one loose-fitting 10-0 nylon suture in the ologen group and a tight suture in the MMC group, according to the manufacturer's recommendations and protocols in previous publications. 8 Only in study group B (trabeculectomy with ologen implant) a cylindrical ologen implant (7 mm diameter) was positioned on top of the scleral flap, to exert pressure on the scleral flap to avoid postoperative hypotonia. Finally, the conjunctiva was closed with a 9-0 polyglactin suture (Vicryl, Ethicon Limited, Edinburgh, UK).…”

“…This implant should prevent the collapse of the subconjunctival space. In animal studies, randomised collagen deposition and microcyst formation after penetrating anti-glaucomatous surgery have been shown in the ologen group 8,9 in contrast to negative controls. Moreover, the biodegradable implant decreased early postoperative scarring.…”

Ex-PRESS outcomes using mitomycin-C, Ologen alone, Ologen with 5-fluorouracil

“…The Ologen collagen matrix is a biodegradable porcine-derived collagen-glycosaminoglycan matrix that has been shown to decrease early post-operative scarring in animal models [6,7]. When Ologen is placed directly over the scleral flap, fibroblasts migrate into the pores.…”