Using a Collagen Matrix Implant (Ologen) Versus Mitomycin-C as a Wound Healing Modulator in Trabeculectomy With the Ex-PRESS Mini Glaucoma Device

Abstract

To compare outcomes between patients undergoing trabeculectomy with an Ex-PRESS mini glaucoma device using mitomycin-C (MMC) to those undergoing the same procedure using a subconjunctival collagen matrix implant (Ologen). All patients underwent a trabeculectomy using an Ex-PRESS shunt. A total of 49 eyes of 37 patients received Ologen, and 50 eyes of 48 patients received MMC. Postoperative data were reviewed over 12 months. Outcomes included mean intraocular pressure (IOP), rate of success in achieving a target IOP (with and without antiglaucoma medications), number of medications used, and rates of complications/reoperations. The mean preoperative IOP was 24.98 mm Hg for the MMC group, and 23.24 mm Hg for the Ologen group (P=0.3). At 12 months postoperatively, the mean IOP was 12.1 mm Hg for the MMC group, and 13.12 mm Hg for the Ologen group (P=0.34). At 12 months, the rate of achieving an IOP≤21 mm Hg off medications (unqualified success) was 84% for the MMC group, and 86% for the Ologen group. There was no statistically significant difference between either group for the rates of achieving a specified postoperative IOP either with (qualified success) or without medications. There was no statistically significant difference between the 2 groups in the mean number of postoperative medications required. Both groups had similar rates of complications, and 1 patient in the MMC group lost light perception after a suprachoroidal hemorrhage. Our results suggest that ologen provides similar rates of surgical success as MMC for patients undergoing a filtering procedure using an Ex-PRESS mini glaucoma device.