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Abstract #26399 Published in IGR 12-3

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

Rosentreter A; Schild AM; Jordan JF; Krieglstein GK; Dietlein TS
Eye 2010; 24: 1449-1457

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PurposeThe aim of this study is to assess the efficacy and complications of trabeculectomy with a biodegradable implant (ologen implant) vstrabeculectomy using mitomycin C (MMC) in patients with medically uncontrolled open-angle glaucoma in a prospective randomised clinical trial.MethodsIn the MMC group (10 patients), trabeculectomy was performed according to standard protocols. In the ologen group (10 patients) after standard trabeculectomy the implant was positioned on top of the scleral flap and no MMC was applied. Follow-up was continued for 12 months after surgery and included testing of intraocular pressure (IOP), visual acuity, visual field, ultrasound biomicroscopy, and filtering bleb score.ResultsThe mean preoperative IOP was 24.8±8.9 mm Hg for all patients enrolled. At 1 year after surgery, the mean IOP was 15.6±2.4 mm Hg in the ologen group (P<0.01, 43% reduction) and 11.5±4.1 mm Hg in the MMC group (P<0.01, 50% reduction). No anti-glaucomatous medication was necessary in the MMC group in the first year of follow-up, whereas five patients in the ologen group required topical treatment. The absolute success rate was 100% in the MMC group and 50% in the ologen group (P=0.01). After 1 year, filtering blebs developed significantly more avascular areas in the MMC group (score=1.4) than in the ologen group (score=2.8; P<0.01).ConclusionThe complete success rate using trabeculectomy with the ologen implant is lower than that achieved by trabeculectomy with MMC. However, the bleb morphology caused more problems in the MMC group (avascularity score).

Department of Ophthalmology, University of Cologne, Köln, Germany.

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Classification:

12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)

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