RESEARCH ARTICLE


Same-Site Deep Sclerectomy Re-Operation with Subconjunctival and Subscleral Collagen Matrix (Ologen™) and Minimal use of Mitomycin C



Pablo Díaz-Aljaro*, Jordi Loscos-Arenas, Pau Romera-Romero, Nevena Romanic-Bubalo, Stefano Grixolli-Mazzon, Valldeperas X
Hospital Universitari Germans Trias i Pujol, Carrer de Canyet S/N, Spain


© 2019 Díaz-Aljaro et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Hospital Universitari Germans Trias i Pujol, Carrer de Canyet S/N, Spain; Tel: +34697889186;
E-mail: pablodiazaljaro@gmail.com


Abstract

Purpose:

This study aimed to evaluate the safety and efficacy of same-site Deep Sclerectomy (DS) re-operation with subconjunctival and subscleral collagen matrix (Ologen™) and minimal use of mitomycin C in cases of late failure blebs.

Methods:

A prospective evaluation of consecutive patients on which same-site DS was performed with subconjunctival and subscleral collagen matrix (Ologen™) and minimal use of mitomycin C; all performed at a single university institution. Intraocular pressure (IOP), number of glaucoma medications, postoperative interventions, postoperative complications and surgical success were registered at 24 hours, 1, 6 and 12 months after the surgery.

Results:

Twenty-five eyes of 25 patients were included in this study. Time from first DS was 55.08 ± 28.16 months. Mean preoperative IOP was 20.88 ± 6.06 mmHg and it was reduced to 16.64 ± 4.02 mmHg, at 12 months after re-operation (p 0,007). At this final visit, requirements for topical medications dropped from a mean of 2.2 ± 1.0 to 0.72 ± 1.0 per patient and no medications were required in 60% of patients. Success was 36 % in criteria A (IOP ≤15mmHg), 72% in criteria B (IOP ≤18 mmHg) and 80 % in criteria C (IOP ≤15 mmHg), 12 months after the second surgery.

Conclusion:

The same-site DS re-operation with subconjunctival and subscleral collagen matrix (Ologen®) and minimal use of mitomycin C is a safe and adequate technique for the reduction of IOP, especially when targeted IOP is not lower than 15mmHg.

Keywords: Glaucoma, Deep sclerectomy, Same site, Reoperation, Ologen, Collagen matrix, IOP.