Evaluation of Subconjunctival Oculusgen Implantation as an Adjunct to Trabeculectomy

Purpose: To evaluate the efficacy and safety of subconjunctival oculusgen implantation when used during trabeculectomy Methods: In this prospective, nonrandomized, interventional case series, 10 eyes of 10 patients with medically uncontrolled open angle glaucoma were enrolled. Conventional fornix based trabeculectomy with implantation of subconjunctival biodegradable collagen implant (oculusgen) was performed in all patients. The preoperative best corrected visual acuity (BCVA), intraocular pressure (IOP) measurement and numbers of antiglaucoma medication were recorded. There were 7 postoperative follow-up visits within 6 months after surgery. After 6 months, follow-up visits were continued every 2-3 months. At each visit, the examination included measurements of BCVA and IOP, slit-lamp biomicroscopy, assessment of cell and flare, bleb evaluation and funduscopy. Any complications were recorded at the end of each examination. Data analysis was performed using SPSS software version 15. Results: Mean duration of follow-up was 11.9 months (range 6-26 months). Mean preoperative IOP was 19.3 mmHg (range 12-25 mmHg) with 2.9 number of IOP lowering medications (range 2-4) and mean postoperative IOP was 15.3 mmHg (range 10-24) at month 6 (P=0.028) and 14.7 (range 10-20) at last visit (P=0.016). Mean IOP lowering medications and IOP reduction after 180 days were 0.4 (range 0-3) (P=0.000) and 4.2 mmHg respectively. Mean IOP lowering medications and IOP reduction at last visit were 0.7 (range 0-3) (P=0.000) and 4.8 mmHg. Overall success at last follow-up was 80%. None of the patients experienced systemic or ocular complication related to oculusgen. Conclusion: Trabeculectomy with implantation of oculusgen is a safe and effective surgical method in patients with open angle glaucoma, but longer duration of follow-up in larger number of patients is needed.