Clinical Ophthalmology (Jan 2023)
A Retrospective Comparison of Ahmed Glaucoma Valve Implants with or without Ologen Collagen Matrix
Abstract
Emilio Rintaro Suzuki Junior,1 Heloisa Andrade Maestrini,2 Aline Domingos Pinto Ruppert,3 Regina Cele Silveira Seixas,3 Ana Flávia Belfort,4 Herika Danielle de Miranda Santos,2 Alberto Basile Neto,5 Marcos Balbino,6 Marcelo Jordão Lopes da Silva7 1Department of Ophthalmology, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, MG, Brazil; 2Department of Ophthalmology, Hospital Oculare, Belo Horizonte, MG, Brazil; 3Department of Ophthalmology, Grupo OPTY – HCLOE – Oftalmologia Especializada, São Paulo, SP, Brazil; 4Department of Ophthalmology, Clínica de Olhos da Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil; 5Department of Ophthalmology, Complexo Hospitalar Padre Bento de Guarulhos, Guarulhos, SP, Brazil; 6Department of Emergency Medicine, Centro Universitário São Camilo, São Paulo, SP, Brazil; 7Department of Ophthalmology, Oftalmocenter Ribeirão Preto, Ribeirão Preto, SP, BrazilCorrespondence: Marcos Balbino, Department of Emergency Medicine, Centro Universitário São Camilo, Cipriano Barata, 1869 – ap. 93. Ipiranga, São Paulo, 04205001, Brazil, Tel +5511-983462354, Email [email protected]: To study the effects of Ologen collagen matrix on the outcomes of the Ahmed glaucoma valve implant.Study Design: Retrospective case-control multicenter study, conducted at four centers, comparing the 6-month outcomes of Ahmed valve implants with or without Ologen.Participants: The study included 125 eyes in a 4:1 pairing (25 patients with Ologen matched to 100 patients without Ologen).Intervention: Ologen was placed over the Ahmed plate in the study group. Success was defined as an intraocular pressure (IOP) ≤ 21 mmHg either with no medication (complete success) or regardless of medications (qualified success). Other outcomes included IOP variation, eye drop use, and surgical complications.Results: Overall, the IOP decreased from 30.72 ± 9.08 to 16.14 ± 4.79 mmHg (p=0.0001). Of the 125 eyes, 26 achieved complete success and 94 achieved qualified success. There was no difference in complete success between the groups (p=0.12); however, there was a difference in qualified success (p=0.01), with better results in the no-Ologen group (80% vs 56%). There were no differences in the decrease in medications (p=0.06), as well as the incidence of complications (p=0.69). Although the need for postoperative surgical reintervention was higher in the no-Ologen group (13% vs 4%), the difference was not significant (p=0.2).Conclusion: The reductions in IOP and number of medications were similar in both groups after 6 months, with similar complication rates. The qualified success rate was lower in the Ologen group, but further studies are needed to clarify the role of Ologen in Ahmed valve implants.Keywords: glaucoma, tube shunts, glaucoma incisional surgery, glaucoma anti-fibrotic agents, postoperative glaucoma hypotony
