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Clinical evaluation of a nonbiodegradable collagen implant as a supraciliary space-maintainer in glaucoma surgery

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First Author: V.Kumar RUSSIA

Co Author(s):    M. Frolov   A. Shradqa   G. Dushina   A. Bezzabotnov   K. Abu Zalaan        

Abstract Details

Purpose:

To evaluate the use of a porous, biologically inert and nonbiodegradable bone collagen implant (BCI) as a supraciliary space-maintainer for enhancing the effectiveness and safety of ab externo cyclodialysis procedure in management of open-angle glaucoma (OAG) in cataract patients.

Setting:

Ophthalmic unit, Khimkinskaya oblastnaya bolnitsa Centre for eye microsurgery "PRO zrenie", Khimki Department of eye diseases, Russian people's friendship university

Methods:

A total of 41 OAG cases (47 eyes) having visually significant cataract were operated upon. After cataract surgery, a valved cyclodialysis tunnel (4mm X 4mm) was made ab externo superiorly and a strip of BCI (6.0X0.5X0.5mm) was inserted into it with its distal end entering anterior chamber. There were 41 eyes (91.5%) with pseudoexfoliation syndrome and 9 eyes (19%) had previously failed filtering surgery. Seven eyes were on 1 hypotensive medication, 17 – on 2, 19 – on 3 and 4 eyes were on 4 medications. Follow up > 12 months. Cases were evaluated as per World glaucoma association's guidelines.

Results:

At 12 months intraocular pressure (IOP) decreased from 20.4±6.1 mmHg to 12.0±2.6 mmHg (a decrease by 41.2%; p=6.4E-08). Medication usage was reduced from 2.4±.8 to .4±.9 (a reduction by 83.3%; p=5.3E-12). There was not a single failure case. Intra-operatively, mild hemorrhage was observed in 9 eyes (19.1%), which stopped simultaneously. On day 1, there were 4 cases with hyphema > 1mm, which resorbed spontaneously. Hypotony was observed in 2 cases at 1 week not requiring any additional intervention. Gonioscopically, a gradual shallowing and closure of the cyclodialysis cleft was noticed in 9 eyes (27.3%) at 6 and 12 months.

Conclusions:

Implantation of a nonbiodegradable porous collagen implant in the supracilairy space as a space-maintainer in management of OAG in cataract patients is safe and effectively decreases IOP.

Financial Disclosure:

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