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1 General aspects (0)   1.1 Epidemiology (7)   1.2 Population genetics (0)   1.3 Pathogenesis (4)   1.4 Quality of life (8)   1.5 Glaucomas as cause of blindness (5)   1.6 Prevention and screening (8) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (6)   2.2 Cornea (14)   2.3 Sclera (3)   2.4 Anterior chamber angle (3)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (6)     2.5.2 Schlemms canal (2)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (0)     2.6.1 Production (0)     2.6.2 Outflow (0)       2.6.2.1 Trabecular meshwork (4)       2.6.2.2 Uveoscleral (1)     2.6.3 Compostion (0)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (3)   2.9 Ciliary body (6)   2.10 Lens (0)   2.11 Vitreous body (0)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (0)   2.13 Retina and retinal nerve fibre layer (21)   2.14 Optic disc (17)   2.15 Optic nerve (5)   2.16 Chiasma and retrochiasmal central nervous system (4)   2.17 Stem cells (1)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (1)   3.2 Electron microscopy (2)   3.3 Immunohistochemistry (3)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (2)     3.4.2 Gene studies (16)   3.5 Molecular biology incl. SiRNA (12)   3.6 Cellular biology (21)   3.7 Biochemistry (0)   3.8 Pharmacology (8)   3.9 Pathophysiology (8)   3.10 Immunobiology (4)   3.11 Pharmacogenetics (0)   3.12 Proteomics (1)   3.13 In vivo imaging (0)     3.13.1 Laser Scanning (0)       3.13.1.1 Confocal Scanning Laser Ophthalmoscopy (0)       3.13.1.2 Confocal Scanning Laser Polarimetry (0)     3.13.2 Optical Coherence Tomography (0)       3.13.2.1 Anterior Segment (0)       3.13.2.2 Posterior Segment (0)     3.13.3 RGC Imaging (4)     3.13.4 Other (0)   3.20 Other (0) 4 Tissue culture of ocular cells (0) 5 Experimental glaucoma; animal models (0)   5.1 Rodent (27)   5.2 Primates (3)   5.3 Other (9) 6 Clinical examination methods (0)   6.1 Intraocular pressure measurement; factors affecting IOP (0)     6.1.1 Devices, techniques (8)     6.1.2 Fluctuation, circadian rhythms (6)     6.1.3 Factors affecting IOP (6)   6.2 Tonography, aqueous flow measurement (see also 2.6) (0)   6.3 Biomicroscopy (slitlamp) (1)     6.3.1 Anterior segment (0)     6.3.2 Posterior segment (0)   6.4 Gonioscopy (1)   6.5 Ophthalmoscopy (0)   6.6 Visual field examination and other visual function tests (0)     6.6.1 Conventional manual (0)     6.6.2 Automated (16)     6.6.3 Special methods (e.g. color, contrast, SWAP etc.) (6)   6.7 Electro-ophthalmodiagnosis (3)   6.8 Photography (0)     6.8.1 Anterior segment (2)     6.8.2 Posterior segment (8)   6.9 Computerized image analysis (0)     6.9.1 Laser scanning (0)       6.9.1.1 Confocal Scanning Laser Ophthalmoscopy (13)       6.9.1.2 Confocal Scanning Laser Polarimetry (7)     6.9.2 Optical coherence tomography (0)       6.9.2.1 Anterior (3)       6.9.2.2 Posterior (22)     6.9.5 Other (0)   6.10 Fluorescein (ICG) angiography (0)     6.10.1 Anterior segment (0)     6.10.2 Posterior segment (0)   6.11 Bloodflow measurements (27)   6.12 Ultrasonography and ultrasound biomicroscopy (6)   6.13 Provocative tests (3)   6.19 Telemedicine (0)   6.20 Progression (8)   6.30 Other (4) 8 Refractive errors in relation to glaucoma (0)   8.1 Myopia (1)   8.2 Hypermetropia (0)   8.3 Contact lenses (0)   8.4 Refractive surgical procedures (1)   8.5 Other (1) 9 Clinical forms of glaucomas (0)   9.1 Developmental glaucomas (0)     9.1.1 Congenital glaucoma, Buphthalmos (6)     9.1.2 Juvenile glaucoma (10)     9.1.3 Syndromes of Axenfeld, Rieger, Peters, aniridia (2)     9.1.4 Other (0)   9.2 Primary open angle glaucomas (0)     9.2.1 Ocular hypertension (0)     9.2.2 Other risk factors for glaucoma (4)     9.2.3 Open angle glaucoma with elevated IOP (1)     9.2.4 Normal pressure glaucoma (4)   9.3 Primary angle closure glaucomas (0)     9.3.1 Acute primary angle closure glaucoma (pupillary block) (3)     9.3.2 Chronic primary angle closure glaucoma (pupillary block) (1)     9.3.3 Plateau iris syndrome (2)     9.3.4 Primary angle closure suspect (2)     9.3.5 Primary angle closure (4)     9.3.10 Other (1)   9.4 Glaucomas associated with other ocular and systemic disorders (0)     9.4.1 Steroid-induced glaucoma (6)     9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera (0)       9.4.2.1 Iridocorneal endothelial syndrome (ICE, incl. irisatrophy) (1)       9.4.2.2 Posterior polymorphous dystrophy (1)       9.4.2.3 Fuchs' endothelial dystrophy (0)       9.4.2.5 Other (1)     9.4.3 Glaucomas associated with disorders of the iris and ciliary body (0)       9.4.3.1 Pigmentary glaucoma (2)       9.4.3.5 Other (0)     9.4.4 Glaucomas associated with disorders of the lens (0)       9.4.4.1 Exfoliation syndrome (11)       9.4.4.2 Glaucomas associated with cataracts (2)       9.4.4.3 Glaucomas associated with lens dislocation (0)       9.4.4.5 Other (0)     9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (0)       9.4.5.1 Neovascular glaucoma (8)       9.4.5.5 Other (2)     9.4.6 Glaucomas associated with inflammation, uveitis (11)     9.4.7 Glaucomas associated with ocular trauma (3)     9.4.8 Glaucomas associated with intraocular tumors (1)     9.4.9 Glaucomas associated with elevated episcleral venous pressure (1)       9.4.10 Glaucomas associated with hemorrhage (2)     9.4.11 Glaucomas following intraocular surgery (0)       9.4.11.1 Ciliary block (malignant) glaucoma (2)       9.4.11.2 Glaucomas in aphakia and pseudophakia (3)       9.4.11.3 Epithelial, fibrous, and endothelial proliferation (0)       9.4.11.4 Glaucomas associated with corneal surgery (2)       9.4.11.5 Glaucomas associated with vitreoretinal surgery (4)     9.4.15 Glaucoma in relation to systemic disease (17)     9.4.20 Other (0) 10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy (3) 11 Medical treatment (0)   11.1 General management, indication (9)   11.2 Cholinergic drugs (2)   11.3 Adrenergic drugs (0)     11.3.1 Epinephrine (0)     11.3.2 Thymoxamine, dapiprazole (0)     11.3.3 Apraclonidine, brimonidine (2)     11.3.4 Betablocker (6)     11.3.5 Other (0)   11.4 Prostaglandins (16)   11.5 Carbonic anhydrase inhibitors (0)     11.5.1 Systemic (1)     11.5.2 Topical (1)   11.6 Osmotic treatment (0)   11.7 Treatment of bloodflow (0)   11.8 Neuroprotection (21)   11.9 Gene therapy (1)   11.13 Combination therapy (2)     11.13.1 Betablocker and pilocarpine (0)     11.13.2 Betablocker and carbon anhydrase inhibitor (5)     11.13.3 Betablocker and brimonidine (0)     11.13.4 Betablocker and prostaglandin (3)     11.13.5 Other (0)   11.14 Investigational drugs; pharmacological experiments (15)   11.15 Other drugs in relation to glaucoma (16)   11.16 Vehicles, delivery systems, pharmacokinetics, formulation (9)   11.17 Cooperation with medical therapy e.g. persistency, compliance, adherence (8)   11.20 Other (0) 12 Surgical treatment (0)   12.1 General management, indication (0)   12.2 Laser iridotomy (4)   12.3 Laser iridoplasty (0)   12.4 Laser trabeculoplasty and other laser treatment of the angle (4)   12.7 Surgical iridectomy (0)   12.8 Filtering surgery (0)     12.8.1 Without tube implant (13)     12.8.2 With tube implant or other drainage devices (15)     12.8.3 Non-perforating (4)     12.8.4 Using laser (0)     12.8.5 Other (0)     12.8.10 Woundhealing antifibrosis (6)     12.8.11 Complications, endophthalmitis (8)   12.9 Trabeculotomy, goniotomy (2)   12.10 Cyclodestruction (2)   12.11 Cyclodialysis (0)   12.12 Cataract extraction (1)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (0)     12.12.3 Phacoemulsification (2)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (2)   12.15 Capsulotomy (0)   12.16 Vitrectomy (2)   12.17 Anesthesia (1)   12.20 Other (1) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (1)   13.2 Outcome (0)     13.2.1 IOP (2)     13.2.2 Visual field (0)       13.2.2.1 Progression (2)       13.2.2.2 Improvement (1)     13.2.3 Other (1) 14 Costing studies; pharmacoeconomics (12) 15 Miscellaneous (31)

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Abstract #24767 Published in IGR 11-4

Biodegradable collagen matrix implant for trabeculectomy

Zelefsky JR; Hsu W-C; Ritch R
Expert Review of Ophthalmology 2008; 3: 613-617

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The biodegradable collagen matrix implant, marketed initially as OculusGen(trademark) and currently as Ologen(trademark) and iGen(trademark), is a novel bioengineered implant designed to be used at the time of trabeculectomy. It consists of a collagen-based scaffold containing thousands of microscopic pores. The implant is placed directly over the scleral flap and influences the healing process by forcing fibroblasts and myofibroblasts to grow into the pores and secrete connective tissue in the form of a loose matrix. This results in decreased scar formation and improved surgical success over trabeculectomy performed without the adjunctive use of antifibrotic agents. Preliminary studies have demonstrated that the biodegradable collagen matrix is effective for use in trabeculectomy, although it may be associated with an increased risk of early postoperative hypotony. Future randomized, controlled trials should help determine its place in glaucoma surgery.

R. Ritch. Einhorn Clinical Research Center, New York Eye and Ear Infirmary, 310 East 14th Street, New York, NY 10003, United States. ritchmd@earthlink.net

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Classification:

12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)

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