Subscleral trabeculectomy with Ologen implant versus mitomycin C in primary infantile glaucoma

The purpose of this study is to compare the effect of subscleral trabeculectomy (SST) augmented with mitomycin C (MMC) versus Ologen implant as secondary procedures for treatment of primary congenital glaucoma.

This is a retrospective study evaluating records of 38 eyes that had undergone SST with MMC (Group M, 17 eyes) versus Ologen (Group O, 21 eyes) by the authors of the study. The study primary endpoint was set at 5-9 months postoperatively, and the secondary endpoint was the last follow-up. A successful outcome was an intraocular pressure (IOP) ≤18 mmHg for infants <1 year and ≤20 mmHg for older ones.

The follow-up duration was 1.25-51 (26.79 ± 27.583) months in Group M and 0.25-103 (22.86 ± 28.991) months in Group O (P = 0.673). The mean preoperative IOP was 28.06 ± 3.929 in Group M and 26.95 ± 6.095 in Group O (P = 0.522). A reduction of IOP was significant in Group M at all follow-up visits but starting at the 4^th postoperative month in Group O. Recorded IOP in Groups M and O, respectively, was 14.9 ± 6.437 and 12.1 ± 5.043 at the primary endpoint and 22.35 ± 8.536 and 22.52 ± 10.152 (P > 0.05) at the secondary endpoint. A successful outcome was achieved in Groups M and O, respectively, in 47.1% and 47.6% at the primary endpoint and in 47.1% and 52.4% at the secondary endpoint (P > 0.05). Cataract, posterior synechiae, and pupillary abnormalities were insignificantly different in both the groups (P = 0.623).

Ologen implant was comparable to MMC in terms of efficacy and safety. Reoperations are inadvisable before 4 months of Ologen implants.