Efficacy and safety of collagen matrix implants in phacotrabeculectomy and comparison with mitomycin C augmented phacotrabeculectomy at 1 year

摘要

Background: To assess the efficacy and safety of collagen matrix implant (Ologen) in phacotrabeculectomy. Design: Prospective, non-randomized, comparative study. Participants: Sixty-six Asian patients. Methods: Thirty three consecutive patients underwent phacotrabeculectomy with Ologen implant and intraocular lens implantation, and 33 subjects recruited as controls underwent surgery with mitomycin C augmentation. Main Outcome Measures: The primary outcome measure was postoperative intraocular pressure at month 12. Additional postoperative treatments, such as bleb needling, and adverse events were secondary outcomes. Results: The overall percentage reduction in intraocular pressure was 13% (95% confidence interval 6.7-19.2) in the Ologen group and 26% (95% confidence interval 14.8-37.9) in the mitomycin C group (P=0.05). At 1 year after surgery (after adjusting for baseline differences), intraocular pressure decreased by 4.2mmHg (95% confidence interval 2.8-5.6mmHg) and 5.6mmHg (95% confidence interval 4.2-7.0mmHg), respectively (P=0.16). Needling with 5-fluorouracil was required more often in the Ologen group (39% vs. 6%; P=0.003). There was similar frequency (<10%) of adverse events in both groups, and there were no complications directly related to the Ologen implant. The blebs in the mitomycin C group had greater central area (P=0.005), maximal area (P=0.01) and height (P=0.005), and were less vascular (P=0.023) than the Ologen blebs. Conclusions: At 1 year, the overall performance of Ologen in combined phacotrabeculectomy was suboptimal compared with combined surgery with mitomycin C. Eyes in the Ologen group required more frequent bleb needling procedures.