Trabeculectomy with collagen matrix implantation versus trabeculectomy with mitomycin C application for the treatment of primary congenital glaucoma

PurposeTo compare the results in terms of the efficacy and safety of collagen matrix implant [Ologen (OLO) implant] versus mitomycin C (MMC) in trabeculectomy for the surgical treatment of primary congenital glaucoma.Materials and methodsTwenty eyes of 15 patients with primary congenital glaucoma were divided into two groups. The first group (MMC group) included 10 eyes that were subjected to trabeculectomy with MMC. The second group (OLO group) included 10 eyes that were subjected to trabeculectomy with a collagen matrix implant (OLO implant). All procedures were performed in Sohag University Hospital. Postoperative evaluation included intraocular pressure (IOP) level, bleb evaluation, complications, and the need for further medication or surgical intervention. The postoperative IOP level was classified into four groups (>21, >17-21, 15-17, and <15 mmHg).ResultsAt the end of the sixth postoperative follow-up month, in the MMC group, only 10% of eyes achieved the target IOP, 10% of eyes had failed surgery, and 80% of eyes had IOP ranging from 15 to 21 mmHg. However, in the OLO group, 40% of eyes achieved the target IOP, 60% of eyes had IOP ranging from 15 to 21 mmHg, and there were no failed surgeries. In terms of complications, the MMC group had a higher rate of complications than the OLO group in the form of early hyphema, bleb leakage, hypotony, and choroidal detachment.ConclusionThis study proved that the use of a collagen matrix implant yields more effective results than MMC when combined with trabeculectomy for the treatment of primary congenital glaucoma. Furthermore, OLO implantation is safe and has low incidences of complications. Because of the small sample size in this study, which limits the statistical comparison between the groups, further larger studies are required to investigate the long-term efficacy and safety of this new device.