Langzeitergebnisse nach Trabekulektomie kombiniert mit Mitomycin C und einem Ologen-Implantat

Zusammenfassung

Hintergrund Das Ologen-Implantat (AeonAstron Europe B. V., Leiden, Niederlande) besteht aus einem biodegradierbaren Kollagen und Glycosaminoglykan und soll eine postoperative Filterkissenvernarbung oder Abkapselung vermeiden.

Methodik In einer retrospektiven klinischen Studie wurden 806 Patienten mit fortgeschrittenem Glaukombefund mit einer Trabekulektomie kombiniert mit Mitomycin C0,02% und einem Ologen-Implantat behandelt. Die Follow-up-Zeit der Studie betrug 8 Jahre.

Ergebnisse Bei 92,6% der Patienten wurde in der Beobachtungszeit eine dauerhafte Drucksenkung von < 16 mmHg ohne das erneute Ansetzen einer drucksenkenden Therapie erreicht. Bei 6,8% der Patienten erfolgten zusätzliche operative Eingriffe bei Überfiltration oder Hypotonie mit Aderhautamotio. Bei der kombinierten Operation mit Phakoemulsifikation und Implantation einer Hinterkammerlinse kam es bei 3,35% der Patienten zur Revision des Filterkissens oder einem erneuten drucksenkenden Eingriff innerhalb von 8 Jahren.

Schlussfolgerung Eine Trabekulektomie kombiniert mit Mitomycin C0,02% und einem Ologen-Implantat schafft einen langfristigen filtrierenden Effekt < 16 mmHg und eine verringerte postoperative Komplikationsrate.

Abstract

Background The Ologen implant consists of a biodegradable collagen and glycosaminoglycan and is intended to avoid postoperative bleb scarring or encapsulation.

Materials and Methods In a retrospective clinical study, 806 patients with advanced glaucoma were treated with trabeculectomy combined with mitomycin C0.02% and Ologen implant. The follow-up time of the study was 8 years.

Results A long-term reduction of the intraocular pressure below 16 mmHg was achieved in 92.6% of the patients without glaucoma eye drops in the long-term observation period. The rate of complication was very low during the postoperative period and additional surgical procedures for over-filtration with subsequent choroidal detachment were seen in 6.8% of the patients. A failure of the combined operation with phacoemulsification and implantation of an intraocular lens resulted in revision of the bleb or the application of compressive sutures in 3.35% of patients within 8 years.

Conclusion The Ologen implant was introduced in glaucoma surgery to increase the effectiveness of trabeculectomy and to reduce the complications. Trabeculectomy combined with mitomycin C0.02% and an Ologen implant provides a satisfactory filtering effect without the undesirable effects of postoperative fibrosis.

Schlüsselwörter

Offenwinkelglaukom - Augeninnendruck - Trabekulektomie - Mitomycin

Key words

open-angle glaucoma - intraocular pressure - trabeculectomy - mitomycin

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