Trabeculectomy with collagen implant for the treatment of glaucoma

Abstract

The goal is to assess the effectiveness and safety of trabeculectomy with collagen implants for glaucoma patients who cannot be managed medically. This research is a case series that intervenes without randomization and focuses on potential outcomes. The study consisted of 76 treated eyes of 76 patients with uncontrollable glaucoma. A thorough examination of the eyes was performed on all patients, and the results were documented. Each patient underwent conventional trabeculectomy surgery using the fornix-based approach. Additionally, a subconjunctival collagen implant known as Ologen was also utilized. We recorded preoperative data such as age, gender, best-corrected visual acuity, intraocular pressure, glaucoma type, and a few preoperative antiglaucoma medications. We recorded the intraocular pressure after surgery, the number of glaucoma medications given after surgery, and any complications that occurred during the postoperative period. Each patient was monitored for a minimum of six months. Before the operation, the average intraocular pressure (IOP) was 34.21 ± 12.5, and the patient took at least two IOP-lowering medications (average 2.3). The postoperative IOP was measured after three months and found to be 13.85±5.42mm Hg, with a p-value of 0.060. On average, the blood pressure decreased by 16.42±6.42 mmHg after six months, with a p-value of 0.056. After six months, it was observed that the medication significantly reduced 1.22 in intraocular pressure (P=<0.001), leading to a notable decrease of 17.79 mmHg. The success rate stood at a commendable 97.36% at the three-month mark, but it reduced to an alarming 88.15% by the last visit. Within just one month after the operation, several complications arose, including three cases of hyphaema, one case of the shallow anterior chamber, and two cases of wound leak. All patients showed gradual improvement with conservative management. However, three of them developed cataracts within three months. For patients who have not responded to topical antiglaucoma medications, to manage intraocular pressure is a dependable and safe surgical procedure that offers an efficient treatment option.