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Klin Monbl Augenheilkd 2022; 239(09): 1147-1154
DOI: 10.1055/a-1500-8230
Klinische Studie

Trabeculectomy with OloGen versus Mitomycin C for the Treatment of Silicone Oil-Induced Glaucoma

Trabekulektomie mit OloGen versus Mitomycin-C-Behandlung von silikonölinduziertem Glaukom
Hisham Samy Shalaby 
Ophthalmology, Ain Shams University Faculty of Medicine, Cairo, Egypt
,
Noureldin Hussein Hashem
Ophthalmology, Ain Shams University Faculty of Medicine, Cairo, Egypt
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Abstract

Aim To compare the intraocular pressure-lowering effect and success rate of trabeculectomy with OloGen to that of trabeculectomy with mitomycin C (MMC) in cases of silicone oil-induced glaucoma.

Materials and Methods Forty eyes of forty patients with elevated intraocular pressure (IOP) after vitrectomy and silicone oil injection (followed by silicone oil removal) were assigned to two groups. Group A included 20 cases who underwent trabeculectomy with OloGen, while group B cases contained 20 cases undergoing trabeculectomy with MMC. The follow-up period was 24 months. Patients enrolled had IOP > 21 mmHg despite being on antiglaucoma medications.

Results The mean postoperative IOP reduction was lower in group A than in group B at all follow-up visits, but this difference was not statistically significant (p > 0.05). Moreover, group A and B patients were found to be similar as regards the need for postoperative antiglaucoma medications on all follow-up visits. The Kaplan-Meier survival analysis curves for the two groups revealed slightly higher success rates in group B than in group A. However, these differences were not statistically significant for both qualified success (IOP ≤ 21 mmHg with or without antiglaucoma medications) and complete success (IOP ≤ 21 mmHg without antiglaucoma medications). There was no significant difference in the postoperative complication rate between the two groups.

Conclusion OloGen implant lowers IOP to a similar extent as MMC when combined with trabeculectomy for the treatment of silicone oil-induced glaucoma, and with comparable success rates. The rate of postoperative complications is similar for OloGen implantation and MMC.

Zusammenfassung

Ziel Vergleich des Augeninnendrucksenkungseffekts und der Erfolgsrate der Trabekulektomie mit OloGen mit der Trabekulektomie mit Mitomycin C (MMC) bei silikonölinduziertem Glaukom.

Material und Methoden 40 Augen von 40 Patienten mit erhöhtem Augeninnendruck (IOD) nach Vitrektomie und Silikonölinjektion (gefolgt von Silikonölentfernung) wurden 2 Gruppen zugeordnet. Gruppe A umfasste 20 Fälle, bei denen eine Trabekulektomie mit OloGen durchgeführt wurde, während Gruppe B 20 Fälle enthielt, bei denen eine Trabekulektomie mit MMC durchgeführt wurde. Die Nachbeobachtungszeit betrug 24 Monate. Die eingeschlossenen Patienten hatten einen IOD > 21 mmHg, obwohl sie Medikamente gegen Glaukom erhielten.

Ergebnisse Die mittlere postoperative IOD-Reduktion war in Gruppe A bei allen Nachuntersuchungen niedriger als in Gruppe B, aber dieser Unterschied war statistisch nicht signifikant (p > 0,05). Darüber hinaus wurde festgestellt, dass die Patienten der Gruppen A und B hinsichtlich des Bedarfs an postoperativen Antiglaukommedikamenten bei allen Nachuntersuchungen ähnlich sind. Die Kaplan-Meier-Überlebensanalysekurven für die beiden Gruppen zeigten geringfügig höhere Erfolgsraten, die in Gruppe B im Vergleich zu Gruppe A beobachtet wurden. Diese Unterschiede waren jedoch sowohl für den begrenzten Erfolg (IOD ≤ 21 mmHg mit oder ohne Antiglaukommedikamente) als auch für den vollständigen Erfolg statistisch nicht signifikant (IOD ≤ 21 mmHg ohne Medikamente gegen Glaukom). Es gab keinen signifikanten Unterschied in der postoperativen Komplikationsrate zwischen den beiden Gruppen.

Schlussfolgerung Das OloGen-Implantat zeigt in Kombination mit einer Trabekulektomie zur Behandlung des durch Silikonöl induzierten Glaukoms einen ähnlichen Effekt auf die Senkung des Augeninnendrucks wie MMC mit vergleichbaren Erfolgsraten. Die Rate der postoperativen Komplikationen ist für die OloGen-Implantation und die MMC analog.

Key words

silicone - glaucoma - trabeculectomy - OloGen - mitomycin-C - randomized clinical trial - retina - pharmacology

Schlüsselwörter

Silikon - Glaukom - Trabekulektomie - OloGen - Mitomycin C - randomisierte klinische Studie - Glaukom - Retina - Pharmakologie


Publication History

Received: 07 January 2021

Accepted: 03 May 2021

Article published online:
01 July 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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