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

Wisam Shihadeh, Belal Alwattar


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: Trabeculectomy, Intraocular pressure, Biodegradable collagen matrix.

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