Mannnan R¹*, Jolly FA², Hossain F³, Bhowmik NC³ and Sayeed A⁴

¹Glaucoma Specialist and Surgeon, Department of Ophthalmology, BIRDEM General Hospital, Dhaka, Bangladesh
²Associate Professor, Department of Ophthalmology, BIRDEM General Hospital, Dhaka, Bangladesh
³Assistant Professor, Department of Ophthalmology, BIRDEM General Hospital, Dhaka, Bangladesh
⁴Professor and Head, Department of Ophthalmology, BIRDEM General Hospital, Dhaka, Bangladesh

*Corresponding Author: Mannnan R, Glaucoma Specialist and Surgeon, Department of Ophthalmology, BIRDEM General Hospital, Dhaka, Bangladesh.

Received: November 01, 2021 ; Published: November 15, 2021

Abstract

Purpose: To compare the surgical outcome of trabeculectomy with Mitomycin-C (MMC) versus trabeculectomy with collagen(ologen) implant in medically uncontrolled, primary open angle glaucoma patients of Bangladeshi population.

Methods: A Quasi experimental study; conducted at BIRDEM General Hospital, Dhaka from July, 2015 to June, 2021 consisting of 36 eyes of 24 patients (> 40 years of age) of medically uncontrolled primary open angle glaucoma(POAG). Study patients were randomly distributed between two comparison groups: namely; GROUP 1: Trabeculectomy with Mitomycin-C and GROUP 2: trabeculectomy with collagen (Ologen) implant. All the surgeries were performed by single surgeon. Total six Post operative follow-up was done up to 12 months after surgery.At each visit, BCVA, IOP, any post operative complications of surgery as well as requirement of any anti-glaucoma drug or possible need of second surgical intervention for lowering IOP were noted.

Results: Mean IOP reduction after surgery was significantly less at all time points in both groups(p<0.05). Considering complete success criteria, survival probability in Ologen group was 94.8% at 6 months and 92.9% (95% CI: 59.1 - 99.0) at 12 months. The corresponding survival probability in MMC group was 95.2 and 93.8% (63.2 - 99.1) at 6 months and 12 months. There were no significant intra-operative complications in any of the eyes in either of the groups.

Conclusion: Surgical outcome of trabeculectomy with MMC was similar to that of trabeculectomy with Ologen implant.

Keywords: Trabeculectomy; Mitomycin-C; Collagen Implant; Surgical Outcome; Open Angle Glaucoma sss

References

1. Cairns JE. “Trabeculectomy. Preliminary report of a new method”. American Journal of Ophthalmology 66 (1968): 673-679.
2. Watson PG and Barnett F. “Effectiveness of trabeculectomy in glaucoma”. American Journal of Ophthalmology 79 (1975): 831-845.
3. Watson PG., et al. “The complications of trabeculectomy: A 20-year follow-up”. Eye (London) 4 (1990): 425-438.
4. Skuta GL and Parrish RK. “2^nd Wound healing in glaucoma filtering surgery”. Survey of Ophthalmology 32 (1987): 149-170.
5. Jampel HD., et al. “Cellular proliferation after experimental glaucoma filtration surgery”. Archives of Ophthalmology 106 (1988): 89-94.
6. Bindlish R., et al. “Efficacy and safety of mitomycin-C in primary trabeculectomy: Five-year followup”. Ophthalmology 109 (2002): 1336-1341.
7. Lama PJ and Fechtner RD. “Antifibrotics and wound healing in glaucoma surgery”. Survey of Ophthalmology 48 (2003): 314-346.
8. Beckers HJ., et al. “Five-year results of trabeculectomy with mitomycin C”. Graefe's Archive for Clinical and Experimental Ophthalmology 241 (2003): 106-110.
9. Katz GJ., et al. “Mitomycin C versus 5fluorouracil in high-risk glaucoma filtering surgery”. Extended follow-up. Ophthalmology 102 (1995): 1263.
10. Greenfield DS., et al. “Endophthalmitis after filtering surgery with mitomycin”. Archives of Ophthalmology 114 (1996): 943.
11. Higginbotham EJ., et al. “Bleb-related endophthalmitis after trabeculectomy with mitomycin C”. Ophthalmology 103 (1996): 650-656.
12. Jampel HD., et al. “Hypotony maculopathy following trabeculectomy with mitomycin C”. Archives of Ophthalmology 110 (1992): 1049-1050.
13. Chen HS., et al. “Control of filtering bleb structure through tissue bioengineering: An animal model”. Investigative Ophthalmology and Visual Science 47 (2006): 5310-5314.
14. Boey PY., et al. “Imaging of blebs after phacotrabeculectomy with Ologen collagen matrix implants”. British Journal of Ophthalmology 95 (2011): 340-344.
15. Papaconstantinou D., et al. “Trabeculectomy with OloGen versus trabeculectomy for the treatment of glaucoma: A pilot study”. Acta Ophthalmology 88 (2010): 80-85.
16. Rosentreter A., et al. “A prospective randomised trial of trabeculectomy using mitomycin C vs an ologen implant in open angle glaucoma”. Eye (Lond) 24 (2010):1449-1457.
17. Wong TT., et al. “The singapore 5-Fluorouracil trabeculectomy study: Effects on intraocular pressure control and disease progression at 3 years”. Ophthalmology 116 (2009): 175-184.

Citation

Citation: Mannnan R., et al. “Surgical Outcome of Trabeculectomy with Mitomycin - C Versus Trabeculectomy with Collagen Implant (Ologen), in Patients of Primary Open Angle Glaucoma: A Tertiary Centre Study".Acta Scientific Ophthalmology 4.12 (2021): 40-45.