Combined trabeculotomy: trabeculectomy with collagen matrix implant in secondary childhood glaucoma

Session Details

Session Title: Glaucoma I

Session Date/Time: Sunday 14/09/2014 | 08:00-09:30

Paper Time: 08:06

Venue: Auditorium

First Author: : N.Makhmudova-Hasanova AZERBAIJAN

Co Author(s): :    E. Kasimov   J. Hasanov           

Abstract Details

Purpose:

The primary objective is to evaluate the efficacy and safety of collagen matrix implant (CMI) in combined trabeculotomy-trabeculectomy (CTT) for the treatment of Secondary Childhood Glaucoma (SCG).

Setting:

Zarifa Aliyeva National Eye Center

Methods:

Three children with SCG were operated upon with CT assisted by collagen matrix implant. CMI was inserted 1 mm over the sclera flap under the limbal based conjunctival flap. Conjunctiva was sutured with absorbable sutures. The first infant was 7 days old boy with partial aniridia and SCG not operated upon with intraocular pressure (IOP) 52 mm Hg in right eye and 54 mm Hg in left eye. The second child was 1 year old girl with Neurofibromatosis 1 and SCG in left eye. IOP was 37 mm Hg under medications. The third child was 6 years old boy with CHED 2 and SCG in both eyes. IOP was 23 mm Hg in right eye and 45 mm Hg in left eye under medications. Follow up was 1 month, 3 month, 6 month, 9 month after surgery. Parameters used were IOP, state of the bleb, corneal diameter, axial length, corneal clarity and cup disc ratio. Success definition: 1. Full success: IOP< 18 mm Hg without medications, clear cornea. 2. Satisfactory success: IOP < 21 mm Hg without medications, clear cornea. 3. Poor success: IOP < 21 mmHg with medications. 4. Failure: IOP > 21 mm Hg.

Results:

CTT with collagen matrix implant in all the patients was successful with IOP 17 mm Hg in right and 18 mm Hg in left eye after 9 months and 18 mm Hg in second child after 6 month. IOP was 14 mm Hg in third child after surgery. Corneal clarity improved and its diameter decreased in first child.

Conclusions:

Biodegradable collagen matrix implants can be used in SCG and reduce the surgical risks and complications of surgery with MMC in infants. It is also an easier and safer alternative than glaucoma valve implants. Longer duration of follow-up in larger number of patients is needed.

Financial Interest:

NONE