Ologen implant versus mitomycin C in combined trabeculectomy and phacoemulsification

Abstract

Purpose: To comparatively evaluate in Indian eyes with coexisting cataract and primary open-angle glaucoma the outcome of mitomycin C (MMC) and Ologen implant as adjunctives in combined phacoemulsification with trabeculectomy. Methods: Eyes with primary open-angle glaucoma that underwent trabeculectomy and phacoemulsification with IOL implantation with either MMC application or Ologen implant between June 2019 and February 2020 were followed up for 12 months. Thirty-four eyes of 34 participants were studied. The primary outcome was intraocular pressure (IOP), and the secondary outcomes were the number of ocular hypotensives, best distance visual acuity (BDVA), and bleb morphology. Results: In 16 eyes treated with MMC and 18 eyes treated with Ologen implant, it was observed that the mean postoperative IOP (14.62 ± 2.89 mm Hg with MMC and 14.56 ± 4.14 mm Hg with Ologen implant) was not significantly different in both groups ( P = 0.47). Number of ocular hypotensives and BDVA were also comparable between the two groups. However, bleb morphology was better with Ologen implantation. One eye in the MMC group developed hypotony which was conservatively managed Conclusion: MMC and Ologen are both effective adjunctives in combined phaco-trabeculectomy. However, the Ologen implant provides better bleb health and safety.

A Brief Review of Historical and Current Trends in Trabeculectomy

“…Recent studies have demonstrated encouraging results when the Ologen implant is used in combined phacoemulsification and trabeculectomy procedures or adjunctively with MMC. 111,[118][119][120] Of note, there have been modifications in the dimensions (reduced thickness) and physical properties (larger matrix pore size and collagen composition) of the implant since results of early trials that may account for the conflicting efficacy of Ologen reported in the literature. 111 The use of thicker, 4 mm implants 121,122 may influence outcomes compared with later versions with 2 mm thickness.…”

“…A study by Yuan et al 117 is the only to report greater postoperative IOP reduction without significant differences in complications after 5-year follow-up. Recent studies have demonstrated encouraging results when the Ologen implant is used in combined phacoemulsification and trabeculectomy procedures or adjunctively with MMC 111,118–120 . Of note, there have been modifications in the dimensions (reduced thickness) and physical properties (larger matrix pore size and collagen composition) of the implant since results of early trials that may account for the conflicting efficacy of Ologen reported in the literature 111 .…”

A Brief Review of Historical and Current Trends in Trabeculectomy

“…Recent studies have demonstrated encouraging results when the Ologen implant is used in combined phacoemulsification and trabeculectomy procedures or adjunctively with MMC. 111,[118][119][120] Of note, there have been modifications in the dimensions (reduced thickness) and physical properties (larger matrix pore size and collagen composition) of the implant since results of early trials that may account for the conflicting efficacy of Ologen reported in the literature. 111 The use of thicker, 4 mm implants 121,122 may influence outcomes compared with later versions with 2 mm thickness.…”

“…A study by Yuan et al 117 is the only to report greater postoperative IOP reduction without significant differences in complications after 5-year follow-up. Recent studies have demonstrated encouraging results when the Ologen implant is used in combined phacoemulsification and trabeculectomy procedures or adjunctively with MMC 111,118–120 . Of note, there have been modifications in the dimensions (reduced thickness) and physical properties (larger matrix pore size and collagen composition) of the implant since results of early trials that may account for the conflicting efficacy of Ologen reported in the literature 111 .…”

A Brief Review of Historical and Current Trends in Trabeculectomy

“…Recent studies have demonstrated encouraging results when the Ologen implant is used in combined phacoemulsification and trabeculectomy procedures or adjunctively with MMC. 111,[118][119][120] Of note, there have been modifications in the dimensions (reduced thickness) and physical properties (larger matrix pore size and collagen composition) of the implant since results of early trials that may account for the conflicting efficacy of Ologen reported in the literature. 111 The use of thicker, 4 mm implants 121,122 may influence outcomes compared with later versions with 2 mm thickness.…”

“…A study by Yuan et al 117 is the only to report greater postoperative IOP reduction without significant differences in complications after 5-year follow-up. Recent studies have demonstrated encouraging results when the Ologen implant is used in combined phacoemulsification and trabeculectomy procedures or adjunctively with MMC 111,118–120 . Of note, there have been modifications in the dimensions (reduced thickness) and physical properties (larger matrix pore size and collagen composition) of the implant since results of early trials that may account for the conflicting efficacy of Ologen reported in the literature 111 .…”

A Brief Review of Historical and Current Trends in Trabeculectomy

“…Recent studies have demonstrated encouraging results when the Ologen implant is used in combined phacoemulsification and trabeculectomy procedures or adjunctively with MMC. 111,[118][119][120] Of note, there have been modifications in the dimensions (reduced thickness) and physical properties (larger matrix pore size and collagen composition) of the implant since results of early trials that may account for the conflicting efficacy of Ologen reported in the literature. 111 The use of thicker, 4 mm implants 121,122 may influence outcomes compared with later versions with 2 mm thickness.…”

“…A study by Yuan et al 117 is the only to report greater postoperative IOP reduction without significant differences in complications after 5-year follow-up. Recent studies have demonstrated encouraging results when the Ologen implant is used in combined phacoemulsification and trabeculectomy procedures or adjunctively with MMC 111,118–120 . Of note, there have been modifications in the dimensions (reduced thickness) and physical properties (larger matrix pore size and collagen composition) of the implant since results of early trials that may account for the conflicting efficacy of Ologen reported in the literature 111 .…”