Surgical Outcome of Mitomycin C-soaked Collagen Matrix Implant in Trabeculectomy

Abstract

Trabeculectomy with mitomycin C-soaked ologen do not seem to exert any synergistic effect with antimetabolites in terms of a reduction in IOP. However, the mitomycin C-soaked collagen matrix implant used in trabeculectomy resulted in comparatively stable IOP and did not aggravate wound healing or scar formation. Encapsulated blebs were generated at a more rapid pace in larger amounts compared with conventional trabeculectomy. The management of encapsulated blebs may be crucial to improving the success rate of surgery.

Trabeculectomy Using Mitomycin C versus an Atelocollagen Implant: Clinical Results of a Randomized Trial and Histopathologic Findings

“…Altogether, the effectiveness of CGMs in preventing cicatrization appears to be lower than that achievable with antimetabolites. In previous trials a higher and more rapid rate of Tenon's cysts was reported in the OLO group [13,26]. This fact is underlined by histopathologic findings after explantation of OLO implants that reveal that fibrous scarring is not prevented by an OLO implant and the artificial gaps of the implant are filled with dense collagenous tissue.…”

“…In one retrospective study the intraoperative administration of MMC (0.1 mg/ml for 1 min) in addition to CGM implantation achieved an IOP level as low as 12.54 ± 1.67 mm Hg 12 months after surgery [27]. In another noncomparative study the use of an MMC-soaked (0.2 mg/ml) OLO implant as an adjuvant in trabeculectomy showed no further synergistic effect related to IOP reduction [26]. However, further prospective studies are needed to establish the further potential of the OLO implant in combination with MMC in penetrating glaucoma surgery.…”

Trabeculectomy with ologen in secondary glaucomas following failed trabeculectomy with MMC: comparative study

“…They found that it did not exert any synergistic effect in terms of a reduction in IOP, but it resulted in comparatively stable IOP and did not aggravate wound healing or scar formation, while encapsulated blebs were more common and developed more rapidly. 19 In our work, the preoperative IOP was insignificantly different between SOAG (group A) and SACG (group B) glaucoma, while postoperative IOP was significantly lower in each group at each follow up period (Po0.001). The percentage drop in IOP in group A was statistically insignificantly different from that in group B at all follow up periods except at 1 month postoperative when group A percentage drop was significantly more than group B (P = 0.006).…”

Trabeculectomy with Ologen versus Mitomycin C in Juvenile Open-Angle Glaucoma: A 1-Year Study

“…Similarly, Min et al [15] studied the wound-healing reaction of a filtering bleb after trabeculectomy using MMC-soaked ologen. They found that it did not exert any synergistic effect in terms of a reduction in IOP, but it resulted in comparatively stable IOP and did not aggravate wound healing or scar formation, while encapsulated blebs were more common and developed more rapidly [15] .…”

“…Early conjunctival leakage was also reported by Rosentreter et al [18] in 30% of their cases undergoing trabeculectomy with ologen. In the study by Min et al [15] , encapsulated blebs occurred in 30% of the eyes; digital massage was performed on 8 of those eyes and needling was performed on 1 eye [15] .…”