Surgical outcome of mitomycin C-soaked collagen matrix implant in trabeculectomy.

PURPOSE

To assess the surgical outcomes and wound healing reaction of a filtering bleb after trabeculectomy using mitomycin C-soaked biodegradable collagen matrix (ologen).

METHODS

Thirty eyes, in which the intraocular pressure (IOP) could not be controlled within the proper range by medication or laser treatment, were targeted in this study. After trabeculectomy with mitomycin C (0.2 mg/mL, 0.1 mL)-soaked ologen, surgical outcomes were assessed by evaluating bleb morphology by the Moorfield bleb grading system, as well as internal reflectivity and wound healing response of the bleb using a slit lamp and ultrasound biomicroscopy. The follow-up period continued for 12 months after surgery.

RESULTS

Twelve months after surgery, 12/30 (40.0%) eyes were considered complete successes and 24/30 (80%) eyes as qualified successes. This rate is similar to the rate of our conventional trabeculectomy. The encapsulated bleb was the most frequent complication (9 eyes) and generally occurred at approximately 2 weeks after surgery. No avascular blebs were observed at final follow-up.

CONCLUSIONS

Trabeculectomy with mitomycin C-soaked ologen do not seem to exert any synergistic effect with antimetabolites in terms of a reduction in IOP. However, the mitomycin C-soaked collagen matrix implant used in trabeculectomy resulted in comparatively stable IOP and did not aggravate wound healing or scar formation. Encapsulated blebs were generated at a more rapid pace in larger amounts compared with conventional trabeculectomy. The management of encapsulated blebs may be crucial to improving the success rate of surgery.