Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
J Glaucoma. 2013 Aug;22(6):456-62. doi: 10.1097/IJG.0b013e31826ab6b1.
To assess the surgical outcomes and wound healing reaction of a filtering bleb after trabeculectomy using mitomycin C-soaked biodegradable collagen matrix (ologen).
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.
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.
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.
评估使用丝裂霉素 C 浸泡的可生物降解胶原基质（ologen）进行小梁切除术的滤过泡的手术效果和伤口愈合反应。
本研究针对 30 只眼，这些眼的眼压（IOP）不能通过药物或激光治疗控制在适当范围内。在进行丝裂霉素 C（0.2mg/ml，0.1ml）浸泡的 ologen 小梁切除术后，通过 Moorfield 滤过泡分级系统评估滤过泡形态，以及使用裂隙灯和超声生物显微镜评估滤过泡的内部反射率和伤口愈合反应，来评估手术效果。术后随访 12 个月。
术后 12 个月，30 只眼中有 12 只（40.0%）被认为是完全成功，24 只（80%）是合格成功。这一比率与我们常规小梁切除术的比率相似。包裹性滤过泡是最常见的并发症（9 只眼），通常在术后约 2 周发生。在最终随访时未观察到无血管滤过泡。
在降低眼压方面，丝裂霉素 C 浸泡的 ologen 与抗代谢物联合使用似乎没有协同作用。然而，在小梁切除术中使用丝裂霉素 C 浸泡的胶原基质植入物导致相对稳定的眼压，并且不会加重伤口愈合或瘢痕形成。与常规小梁切除术相比，包裹性滤过泡的形成速度更快，数量更多。包裹性滤过泡的处理可能是提高手术成功率的关键。
