Abstract

FR.11.04

First experiences with the OculusGen^TM collagen-matrix-implant in glaucoma surgery

Ruokonen P., Rieger R., Berndt S., Mai C., Rieck P.
Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Klinik für Augenheilkunde

Objective: Scarring in the filtration area is the major limiting factor for the success of penetrating glaucoma operations. The modulation of wound healing with toxic agents, e.g. 5-fluorouracil or mitomycin-C, promotes success, but increases the rate of severe complications. An alternative could be an implantation of a biodegradable, porous collagen-matrix into the subconjunctival space, providing a physiologic regeneration of tenon and conjunctiva.
Methods: A standard trabeculectomy was performed with use of the OculusGen Collagen-matrix-implant in 10 eyes of 10 patients in the age of 64.7±10.8 years with chronic open angle glaucoma and increased risk of wound healing and conjunctival scar formation.
Results: Intra-operatively no complications occurred. The IOP decreased from 29.3±6.7 mmHg with 3.3±0.5 antiglaucomatous drugs to 13.7±4.4 mmHg without topical treatment after one month and to 15.4±3.3 mmHg after three months. In two cases, surgical intervention was necessary due to ocular hypotony. Formation of tenon-cysts with increased IOP was found in three cases and was treated with needling with 5-FU-injection. In one case repeated operations were necessary, including trabeculectomy with mitomycin-C and cyclophotocoagultion.
Conclusions: Early postoperative results of patients after trabeculectomy without mitomycin-C and using a collagen-matrix-implant, are promising. An intensive postoperative care is still necessary.

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