Posters

Long-term follow-up of a biodegradable subconjunctival collagen-glycosaminoglycan matrix in revisions of late onset glaucoma filtering bleb leaks

Poster Details

First Author: O. Smith UNITED STATES

Co Author(s):    R. Fellman   M. Butler   D. Grover   D. Godfrey   M. Emanuel        

Abstract Details

Purpose:

Our purpose was to describe use of Ologen™an implantable biodegradable collagen - glycosaminoglycan matrix for bleb revision in patients with avascular cystic blebs associated with bleb leaks or discomfort following trabeculectomy with Mitomycin C and also to asses the Long term surgical outcome and wound healing reaction with its use in a retrospective case series .

Setting:

A retrospective review of charts of patients who had bleb revisions with Ologen™ done at the Glaucoma Associates of Texas, Dallas, Texas USA before August 2013.

Methods:

Seven eyes of seven patients with an avascular cystic bleb configuration associated with a bleb leak or dysesthesia that underwent bleb revisions with Ologen™ with at least 18 months of follow up were included. All patients had excision of avascular conjunctival tissue and limbal advancement of the conjunctiva after placing Ologen over the scleral flap with no adjunctive use of antimetabolite. None of the patients had additional sutures placed in the scleral flap. Data collected included patient demographics, pre and post operative vision, intraocular pressure and external photos of pre and post operative bleb morphology.

Results:

A total of seven eyes of seven patients with a mean age of 71.5 years that had revision of cystic avascular blebs with Ologen™ for bleb leaks and bleb dysesthesia were included in the review. Patients had a mean preoperative IOP of 5.2mmHg (Range 0-10mmHg), and mean post operative IOP of 10.2 mmHg (Range 7-13mmHg) at last follow up. Average follow up postoperatively was 32.8 months (Range 21-39 months). All patients were controlled off glaucoma medication at their last follow up visit with diffuse posterior mildly vascular blebs. There were no early or recurrent bleb leaks in the follow up time frame.

Conclusions:

The use of Ologen™ proposes an additional surgical tool in the treatment of cystic avascular blebs with or without associated leaks. Following its use during surgical bleb revisions, there was an improvement in bleb morphology and appearance and maintenance of bleb function and intraocular pressure control in all patients for the long term. There was also an improvement in intraocular pressure in patients with hypotony .

Financial Disclosure:

NONE