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

• Published in: Ophthalmic research Vol. 57; no. 4; p. 230
• Main Authors: El-Sayyad, Fathi, El-Saied, Heba Magdy Ahmed, Abdelhakim, Mohamad Amr Salah Eddin
• Format: Journal Article
• Language: English
• Published: Switzerland 01.01.2017
• Subjects: Adolescent; Adult; Antibiotics, Antineoplastic - pharmacology; Collagen - pharmacology; Female; Follow-Up Studies; Glaucoma, Open-Angle - diagnosis; Glaucoma, Open-Angle - physiopathology; Glaucoma, Open-Angle - surgery; Glycosaminoglycans - pharmacology; Humans; Intraocular Pressure; Male; Mitomycin - pharmacology; Polymers; Prospective Studies; Time Factors; Tomography, Optical Coherence; Trabeculectomy - methods; Treatment Outcome; Young Adult
• ISSN: 1423-0259
• DOI: 10.1159/000456719

We assessed bleb morphology and the intraocular pressure (IOP)-lowering effect of trabeculectomy with ologen compared to mitomycin C (MMC) in juvenile open-angle glaucoma (JOAG). This is a prospective interventional comparative study conducted on 40 eyes (20 patients) with medically uncontrolled JOAG, randomly operating one eye for trabeculectomy with ologen (group A: 20 eyes) and the other with MMC (group B: 20 eyes). IOP measurement, SITA standard perimetry, and spectral domain optical coherence tomography (OCT) for retinal nerve fiber layer (RNFL) thickness were all done pre- and postoperatively. Postoperative blebs were assessed clinically using the Moorfields bleb grading system (MBGS) and anterior segment OCT (AS-OCT). All patients were examined for up to 1 year postoperatively. The mean postoperative IOP was statistically significantly lower than the mean preoperative IOP at each follow-up in each group. At 1 year, the mean postoperative IOP was significantly lower in group A. According to the MBGS, blebs with an ologen implant showed significantly better scoring than those with MMC. AS-OCT showed that ologen-induced blebs had significantly more fluid-filled spaces, cleavage planes, and less fibrosis. Ologen resulted in a lower long-term postoperative IOP, a better bleb morphology, and fewer complications. Our results suggest that ologen may be a useful alternative to MMC in JOAG.