Tube Shunt Revision With Excision of Fibrotic Capsule Using Mitomycin C With and Without Ologen—a Collagen Matrix Implant: A 3-Year Follow-up Study

Salimi, Ali; Kovalyuk, Natalya; Harasymowycz, Paul

doi:10.1097/ijg.0000000000001371

Cited by 10 publications

(4 citation statements)

References 41 publications

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“…Removal of the fibrous capsule improves short-term IOP control, but does not typically yield long-term results due to frequent re-encapsulation. Unfortunately, Ologen does not seem to improve these results in cases of adult glaucoma [25]. Anecdotally, we have also seen minimal benefit of Ologen in revision of AGVs in pediatric glaucomas.…”

Section: Discussionmentioning

confidence: 82%

Ologen augmentation of Ahmed glaucoma drainage devices in pediatric glaucomas

2021

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Background Limited data exists on the effectiveness of the collagen matrix, Ologen, on increasing Ahmed glaucoma valve (AGV) success in childhood glaucomas. Methods Ocular examination and surgical details of pediatric patients who underwent AGV placement ± Ologen augmentation between 2012 and 2020. Complete success was defined as intraocular pressure (IOP) between 5 and 20 mmHg without glaucoma medications and additional IOP-lowering surgeries. Qualified success was defined as above, except IOP control maintained with or without glaucoma medications. Results Twenty-two eyes of 16 patients underwent AGV placement of which 6 eyes had Ologen-augmentation (OAGV) and 16 eyes had conventional surgery (CAGV). Average age was 6.4 ± 5.1 years with 4.2 ± 2.5 follow-up years. There was no difference in age, number of previous surgeries, and preoperative IOP and glaucoma medications. At final follow-up, success rate was 100% (5 eyes complete, 6 eyes qualified) in the OAGV group compared to 31% (0 eyes complete, 5 eyes qualified) in the CAGV group. One and two-year survival rates were 100% for OAGV compared to 62 and 38% for CAGV. Postoperative IOP was significantly lower at 1-month and final follow-up (p = 0.02) as was the number of glaucoma medications at 3, 6, 12-months and final follow-up (p < 0.05) in the OAGV group. Conclusions Ologen-augmentation increased the success and survival rates of AGVs in childhood glaucomas. Further, Ologen mitigated the hypertensive phase and decreased medication dependency. Longer follow-up with a greater number of eyes is required to fully evaluate the effectiveness of OAGV.

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Section: Discussionmentioning

confidence: 82%

Ologen augmentation of Ahmed glaucoma drainage devices in pediatric glaucomas

2021

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“…For statistical analyses, BCVA scores were converted to the logarithm of the minimum angle of resolution (logMAR). IOP spike was defined as an increase in IOP of > 50% or > 10 mmHg, relative to the preoperative IOP [ 56 , 57 ]. To limit the bias from postoperative conditions and to ensure that the postoperative outcomes of eyes can be associated with CE-TMS, postoperative data of eyes that underwent additional glaucoma surgeries were censored in the analysis of subsequent follow-up time points.…”

Section: Methodsmentioning

confidence: 99%

Long-term outcomes of two first-generation trabecular micro-bypass stents (iStent) with phacoemulsification in primary open-angle glaucoma: eight-year results

2021

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Background The short- and medium-term outcomes of iStent have been extensively studied; however, only few studies have investigated its long-term outcomes. Here, we assessed the long-term efficacy and safety of two iStents with concomitant cataract surgery in glaucomatous eyes while also evaluating measures of disease stability using visual field and optical coherence tomography (OCT) of the optic nerve and the macula throughout 8 years of follow-up. Methods This longitudinal, single-center consecutive case series included glaucomatous eyes that underwent implantation of two first-generation trabecular micro-bypass stents (iStent) with concomitant cataract surgery. Eight-year efficacy outcomes included mean intraocular pressure (IOP) and medications, as well as surgical success. Eight-year safety outcomes included best-corrected visual acuity (BCVA), visual field mean deviation (VF-MD), cup-to-disc ratio (CDR), retinal nerve fiber layer (RNFL) thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness, and adverse events. Results A total of 62 eyes with primary open-angle glaucoma (POAG) were included. At 8 years postoperative, IOP reduced by 26% from 19.2 ± 3.9 mmHg preoperatively to 14.2 ± 2.4 mmHg (P < 0.001), 91.1% of eyes achieved IOP ≤ 18 mmHg (vs. 51.6% preoperatively), 69.6% of eyes achieved IOP ≤ 15 mmHg (vs. 14.5% preoperatively), and 25% of eyes achieved IOP ≤ 12 mmHg (vs. 1.6% preoperatively). Medication use decreased by 17.9% from 2.8 ± 1.1 preoperatively to 2.3 ± 1.2 (P = 0.018). Surgical success was 90%, as six eyes underwent subsequent glaucoma surgeries. Safety measures of BCVA, CDR, RNFL thickness and GC-IPL thickness remained stable through 8 years postoperative. VF-MD remained stable until postoperative year 5 and subsequently progressed according to the natural history of glaucomatous disease. Conclusions Implantation of two iStents with concomitant cataract surgery is an effective and safe treatment option for surgery-naïve POAG eyes, evidenced by significant IOP and medication reductions, reasonable surgical success, and favorable safety outcomes, throughout the 8-year follow-up. Our data additionally supports the efficacy of this combined procedure in stabilizing or slowing disease progression.

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“…Demographic, baseline and postoperative clinical data were extracted from patients' charts. Efficacy measures included changes in IOP (measured using the Goldman applanation tonometry) and anti-glaucoma medications (scored according to the number of active pharmacologic classes) [30,31]. Safety comprised intra-or postoperative adverse events, best-corrected visual acuity (BCVA), cup-to-disc ratio (CDR), visual field mean deviation (VF-MD), increase in the number of glaucoma medications or secondary glaucoma interventions for uncontrolled IOP.…”

Section: Outcome Measures and Data Analysismentioning

confidence: 99%

Second-Generation Trabecular Micro-Bypass (iStent inject) with Cataract Surgery in Eyes with Normal-Tension Glaucoma: One-Year Outcomes of a Multi-Centre Study

Salimi

Clement²,

Shiu³

et al. 2020

Ophthalmol Ther

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Purpose: The efficacy and safety of the trabecular micro-bypass stents (iStent and iStent inject) have been well documented in various open-angle glaucoma subtypes. However, their outcomes remain understudied in normal-tension glaucoma (NTG). The present study aimed to assess the 1-year outcomes related to the implantation of two second-generation trabecular micro-bypass stents (iStent inject) concomitant with cataract surgery (CE-TMS), exclusively in eyes with NTG. Methods: This multi-center, consecutive case series included eyes with cataract and normaltension glaucoma that underwent CE-TMS to reduce intraocular pressure or glaucoma medication use. The 12-month efficacy measures included change in average intraocular pressure (IOP) and medication burden. Safety included change in best-corrected visual acuity, cup-todisc ratio, visual field mean-deviation and retinal nerve fiber layer thickness. Intra-or postoperative adverse events were noted. Results: A total of 62 eyes with mild-to-severe NTG and average preoperative IOP of 15.82 ± 2.94 mmHg on 1.50 ± 1.28 glaucoma medications were included. Postoperatively, IOP declined by 22% from 15.82 ± 2.94 mmHg to 12.32 ± 2.58 (p \ 0.001), all eyes had IOP B 18 mmHg (versus 74% preoperatively), and half had IOP B 12 mmHg (versus 15% preoperatively). Medication burden decreased by 70% from 1.50 ± 1.28 to 0.45 ± 0.86 (p \ 0.001), and 73% of the eyes were medication-free (versus 23% preoperatively). Safety was favorable, with no evidence of sight-threatening adverse events. Conclusion: Implantation of iStent inject (two second-generation trabecular micro-bypass Digital Features To view digital features for this article go to

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Tube Shunt Revision With Excision of Fibrotic Capsule Using Mitomycin C With and Without Ologen—a Collagen Matrix Implant: A 3-Year Follow-up Study

Cited by 10 publications

References 41 publications

Ologen augmentation of Ahmed glaucoma drainage devices in pediatric glaucomas

Ologen augmentation of Ahmed glaucoma drainage devices in pediatric glaucomas

Long-term outcomes of two first-generation trabecular micro-bypass stents (iStent) with phacoemulsification in primary open-angle glaucoma: eight-year results

Second-Generation Trabecular Micro-Bypass (iStent inject) with Cataract Surgery in Eyes with Normal-Tension Glaucoma: One-Year Outcomes of a Multi-Centre Study

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