Efficacy of Utilizing a Biodegradable Collagen Matrix in Trabeculectomy: The First Jordanian Experience

Wisam Shihadeh, Belal Alwattar

Abstract


Purpose: To evaluate the efficacy and safety of using a biodegradable collagen matrix in glaucoma filtering surgery
Methods: We treated nine eyes of nine patients with moderate to advanced open angle glaucoma and uncontrolled intraocular pressure (IOP) on maximally tolerated medical treatment. Fornix-based trabeculectomy was performed in all patients and a biodegradable collagen matrix implant was inserted over the flap and underneath the conjunctiva.
Results: Mean age was 37.9 years (range: 16-68). Mean follow up was 7.9 months (range: 3-18). With successful IOP control defined as IOP ≤ 21 mmHg with at least 20% reduction from baseline on the same or fewer number of pre-trabeculectomy medications, 8 out of 9 eyes (88%) fit the criteria for success over the course of follow up. Among all eyes with ≥ 3 months of follow up there was a significant drop in IOP from pre-trabeculectomy 3 months postoperatively (p ‹ 0.05). The percentage of patients requiring › 2 medications declined from 100 %( 9/9) at pre-trabeculectomy to 11% (1/9) at 3 months (p ‹ 0.05). The patient who did not meet the criteria of success regained successful IOP control with bleb needling done 6 weeks after the initial surgery. One eye developed postoperative hypotony for which bleb revision was required.
Conclusion: The use of biodegradable collagen matrix implant appears to hold promise as a tool to increase success rate of glaucoma filtration surgery. Further studies are needed to evaluate the long term results and compare this against the use of antifibrotics in trabeculectomy.

Keywords


Keywords: Trabeculectomy, Intraocular pressure, Biodegradable collagen matrix.

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