Efficacy of trabeculectomy combined with collagen implant and mitomycin C compared to with mitomycin C alone in glaucoma: a retrospective cohort study.

AIM

To compare trabeculectomy with mitomycin C (MMC) alone to trabeculectomy with a combination of MMC and Ologen implant in glaucoma patients.

METHODS

A retrospective cohort study including 94 eyes recruited in two groups [50 in the mitomycin C (MMC) group and 44 in the combined Ologen+MMC (OLO) group]. The medical charts of the patients were collected and analyzed at different time points: 1d, 10-30d, 3-5mo, 6-9mo, 1, 2, and 3y postoperatively. We assessed the intraocular pressure (IOP) reduction, cup-disc (CD) ratio, visual acuity (VA), bleb morphology, and complications.

RESULTS

Both groups showed a significant reduction of the mean IOP from 28.8 to 10 mm Hg in 1 and 2y. However, no significant difference was noticed between both groups. We observed a stable visual acuity in 40% and 11.8%, improved in 20% and 41.2%, and worsened in 40% and 47.1% in the MMC and OLO groups, respectively. Complications were statistically significantly lower in the OLO group than in the MMC group. Bleb morphology showed statistically significant differences between the groups, with grade C blebs being more prevalent in the OLO group (43.2% in 1y) compared to the MMC group (16% in 1y) and flat blebs being more prevalent in the OLO group (43.2% in 2y) compare to MMC group (20% in 2y). Both MMC and OLO groups were effective in reducing IOP.

CONCLUSION

The combined use of the Ologen implant and MMC may provide better outcomes in terms of preserving the optic nerve structure, reducing complications, and maintaining stable bleb morphology postoperatively.