The authors report a retrospective, observational case series of a Japanese cohort. 12 consecutive implantations of ologen in nine eyes of nine subjects (five men, four women; mean age ±SD, 72.1±12.7 years) who underwent subconjunctival implantation of the device to treat hypotony after glaucoma filtration surgery. Six subjects had undergone a LEC and three had undergone EX-PRESS shunt surgeries. MMC was used in all the eyes except one. The duration between the last glaucoma surgery and the initial ologen implantation was longer than two years in seven (78%) eyes. Before the initial implantation, the treatments that failed included viscoelastic injection into the anterior chamber in four (44%) eyes, conjunctival suturing in two (22%) eyes, transient coverage of the leak point by posterior conjunctiva in one (11%) eye, and topical autologous serum use in one (11%) eye. Two (22%) eyes had a history of a bleb infection. After the initial implantation, three (33.3%) eyes required a second implantation (two cases for recurrence of bleb leakage and one case for insufficient increase in the IOP). After a mean follow-up of 12.6±6.8 months, the mean preoperative IOP of 3.8±2.7mmHg increased significantly (P=0.0001 by the paired t-test) to 9.0±3.2mmHg. No eye required glaucoma medication to control the IOP. No vision-threatening complication developed in association with the surgery, and the best-corrected visual acuity (BCVA) did not decrease at the last follow-up visit, except for one eye in which the BCVA decreased because of glaucoma progression. Limitations include, the same race cohort, the absence of a control group, retrospective study design, and short follow-up. Also the possibility cannot be excluded that the dissection of scar tissue could have released pressure inside the bleb and accompanying bleeding in the bleb has been associated with resolution of the hypotony and bleb leakage independent of the ologen implantation. However, the use of ologen implants adds to the available options for the management of hypotony with leaking blebs.

Subconjunctival implantation of Ologen Collagen Matrix to treat ocular hypotony after filtration glaucoma surgery.
Tanito M, Okada A, Mori Y, et al.
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Sofia Rokerya

MBBS MRCOphth FRCSI, King's College University Hospital, UK.

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