Secondary subconjunctival implantation of a biodegradable collagen-glycosaminoglycan matrix to treat ocular hypotony following trabeculectomy with mitomycin C

作者：Dietlein T S^*; Lappas A; Rosentreter A

来源：British Journal of Ophthalmology, 2013, 97(8): 985-988.

DOI：10.1136/bjophthalmol-2013-303357

• Glaucoma

Aim %26lt;br%26gt;Biodegradable collagen glycosaminoglycan matrices (CGM) have been introduced to glaucoma filtration surgery in order to prevent scarring of the filtering bleb. In this retrospective case series, we describe a new surgical concept for treating symptomatic ocular hypotony following filtration surgery with mitomycin C by a secondary subconjunctival implantation of a CGM. %26lt;br%26gt;Methods %26lt;br%26gt;Depending on bleb morphology, a CGM implant with a diameter of 6 or 12mm was placed subconjunctivally on the scleral flap in 12 eyes displaying symptomatic ocular hypotony with (n=2) or without (n=10) bleb leakage. Median period between trabeculectomy and this intervention was 4.5months (range, 1-72months). %26lt;br%26gt;Results %26lt;br%26gt;Mean intraocular pressure significantly increased from 4.4 +/- 1.4mmHg to 9.9 +/- 2.8mmHg (p%26lt;0.0001) over a median follow-up of 6months (range, 2-18months). Mean visual acuity improved significantly (p=0.0012). Postoperative complications included implant re-exposure in one eye and persistent choroidal detachment requiring resurgery in another eye. %26lt;br%26gt;Conclusions %26lt;br%26gt;Subconjunctival implantation of CGM may present an additional surgical tool in the treatment of symptomatic ocular hypotony after filtering surgery. The mechanism of action may be counter-pressure to the scleral flap and secondary wound healing around the CGM scaffold. Long-term observations are needed to fully evaluate this new surgical concept.

• 出版日期2013-8