Abstract
BackgroundTo study the efficacy of the biodegradable collagen implant Ologen® as an adjuvant in phaco-viscocanalostomy in patients with coexisting cataract and primary open angle glaucoma.MethodsThis prospective, interventional, randomized clinical study was done at Alpha Vision Center, Zagazig, Egypt. Patients with coexisting cataract and glaucoma were randomized to receive either phaco-viscocanalostomy (Phacovisco group) (39 eyes) or phaco-viscocanalostomy with Ologen® implant (OloPhacovisco group) (40 eyes). Follow-up period was 2 years. Nd:YAG laser goniopuncture was done in cases where the intraocular pressure (IOP) was elevated above 21 mmHg after discontinuation of corticosteroid eye drops at any follow-up visit.ResultsNo significant operative or postoperative complications (other than failure) were encountered in either group. At 2 years follow-up, the mean IOP level was statistically significantly decreased in the OloPhacovisco group (p = 0.02) and complete success occurred in 23 eyes (59.0%) in the Phacovisco group and in 32 eyes (80.0%) in the OloPhacovisco group. There was a statistically significant higher success rate regarding complete success in patients that received Ologen® implant (p = 0.04).ConclusionsOlogen® implant improved the success rate of phaco-viscocanalostomy. Larger studies with longer follow-up periods may be required to confirm these findings.Trial registrationThis trial was retrospectively registered on 20/12/2018 under the number (NCT03782051).
Highlights
To study the efficacy of the biodegradable collagen implant Ologen® as an adjuvant in phacoviscocanalostomy in patients with coexisting cataract and primary open angle glaucoma
Forty-one eyes were allocated to the Phacovisco group and 40 eyes were allocated to the OloPhacovisco group
Non-penetrating glaucoma surgeries have a significant intraocular pressure (IOP) reducing effect and offer some advantages over the conventional gold standard trabeculectomy for minimizing postoperative complications, such as excess filtration that may lead to prolonged flat anterior chamber, persistent hypotony and choroidal detachment and bleb-related complications, e.g. encysted bleb that may lead to late failure and bleb-related infections [1,2,3,4]
Summary
To study the efficacy of the biodegradable collagen implant Ologen® as an adjuvant in phacoviscocanalostomy in patients with coexisting cataract and primary open angle glaucoma. Surgical treatment of glaucoma is indicated in cases of failure of medical treatment. Trabeculectomy is considered the standard surgical treatment of glaucoma. Non-penetrating glaucoma surgeries, e.g. viscocanalostomy and deep sclerectomy, are becoming good alternatives. Viscocanalostomy has fewer complications than trabeculectomy, e.g. bleb leak, hypotony and bleb-related infections [1,2,3,4]. Since the prevalence of both cataract and glaucoma increases with age, phakic patients who are scheduled for. A biodegradable porous collagen-glycosaminoglycan copolymer matrix implant (Ologen®) is a simple chemical analog of extracellular matrices and has been used as an adjuvant to increase the long-term success of trabeculectomy. The degradation time of this type of implant is around 180 days; this implant consists of porcine based, lyophilized, crosslinked type I atelocollagen (≥ 90%) and
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