Use of a Collagen Matrix Implant as an Adjuvant in Combined Surgery Involving Phacoemulsification and Non-penetrating Deep Sclerectomy.

AIM: To assess the efficacy and safety of the Ologen™ collagen matrix as an adjuvant for combined phacoemulsification and non-penetrating deep sclerectomy (Phaco-NPDS), in addition to mitomycin C (MMC).

METHODS: This was a longitudinal retrospective comparative study of eyes treated with Phaco-NPDS, with (Group 1) or without (Group 2) an Ologen™ collagen matrix implant, in addition to MMC. The main outcome measures were operative success [absolute success: intraocular pressure (IOP) <18▒mm Hg and an at least 20% reduction from baseline without medication; relative success: IOP <18▒mm Hg and at least 20% reduction from baseline IOP with or without medication]; mean reductions (%) in IOP and medication use; number of postoperative reinterventions (goniopuncture, needling, reoperation); and number of complications.

RESULTS: The mean age of the study population (N=100) was 72.0±9.7 years. Groups 1 (n=51) and 2 (n=49) achieved absolute success rates of 72.5% and 55.1%, respectively (P=0.054), and relative success rates of 90.2% and 83.7%, respectively (P=0.251). From a similar baseline IOP (19.8 and 20.7▒mm Hg in Groups 1 and 2, respectively, P=0.527), eyes in Group 1 achieved a significant lower 12-month IOP (11.7 vs. 14.5▒mm Hg, respectively, P=0.002) and a lower rate of medication use (0.2 vs. 0.9, respectively, P<0.001). Eyes in Group 2 presented with a higher rate of bleb failure (12.2% vs. 2.0%, P=0.028), leading to a higher rate of needling procedures (38.8% vs. 2.0%, P<0.001) during the postoperative period.

CONCLUSIONS: The adjunctive use of Ologen™ collagen matrix in addition to MMC during Phaco-NPDS was associated with a higher rate of absolute success, a lower mean IOP at 12 months, a lower rate of bleb failure, and a lower rate of postoperative bleb needling.