Tanito Masaki, Sano Ichiya, Ikeda Yoshifumi, Fujihara Etsuko
Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Japan.
Case Rep Ophthalmol. 2018 Jan 5;9(1):9-16. doi: 10.1159/000485549. eCollection 2018 Jan-Apr.
To report the results using an ologen Collagen Matrix as a patch graft in eyes with tubal exposure after tube shunt surgery.
Case 1 was an 82-year-old man with tubal exposure in his right eye 26 months after receiving a Baerveldt glaucoma implant. The tube was covered by surrounding conjunctival tissue combined with subconjunctival placement of an ologen Collagen Matrix as a patch graft. Two years after implantation, the tube was not exposed. Anterior-segment optical coherence tomography (AS-OCT) showed dense conjunctival tissue over the tube. Case 2 was an 82-year-old man with peripheral keratitis, anterior scleritis, and secondary glaucoma in the right eye who underwent tube shunt surgery using an Ahmed glaucoma valve and cataract surgery. Intraoperatively, scleritis-related scleral thinning prevented the tube from being covered fully by an autologous scleral flap. An ologen Collagen Matrix was placed over the scleral flap as a patch graft. Seventeen months after implantation, the tube was not exposed. Case 3 was a 52-year-old man with diabetic maculopathy and steroid-induced glaucoma in the right eye who underwent tube shunt surgery using an Ahmed glaucoma valve. Intraoperatively, a flap defect prevented the tube from being covered fully by an autologous scleral flap. An ologen Collagen Matrix was placed over the scleral flap as a patch graft. Three weeks postoperatively, AS-OCT showed thick subconjunctival tissue over the tube. Three months after implantation, the tube was not exposed.
The ologen Collagen Matrix can be used successfully as a patch graft to prevent and treat tubal exposure after tube shunt surgery.
报告使用ologen胶原基质作为补片移植片治疗分流管手术后出现分流管暴露的眼部情况的结果。
病例1为一名82岁男性，在接受Baerveldt青光眼植入物26个月后右眼出现分流管暴露。分流管用周围结膜组织覆盖，并在结膜下放置ologen胶原基质作为补片移植片。植入两年后，分流管未再暴露。眼前节光学相干断层扫描（AS-OCT）显示分流管上方有致密的结膜组织。病例2为一名82岁男性，右眼患有周边角膜炎、前巩膜炎和继发性青光眼，接受了使用Ahmed青光眼阀的分流管手术和白内障手术。术中，与巩膜炎相关的巩膜变薄导致分流管无法被自体巩膜瓣完全覆盖。在巩膜瓣上方放置ologen胶原基质作为补片移植片。植入17个月后，分流管未再暴露。病例3为一名52岁男性，右眼患有糖尿病性黄斑病变和类固醇性青光眼，接受了使用Ahmed青光眼阀的分流管手术。术中，瓣缺损导致分流管无法被自体巩膜瓣完全覆盖。在巩膜瓣上方放置ologen胶原基质作为补片移植片。术后三周，AS-OCT显示分流管上方结膜下组织增厚。植入三个月后，分流管未再暴露。
ologen胶原基质可成功用作补片移植片，以预防和治疗分流管手术后的分流管暴露。
