Long-Term Outcomes of Trabeculectomy with Collagen Matrix Implant as a Bevacizumab Depot

To report the long-term outcomes of trabeculectomy with collagen implant as bevacizumab depot in eyes with uncontrolled glaucoma.

In this retrospective non-comparative interventional study, medical records of patients (age ≥18 years) who underwent trabeculectomy with Ologen implant as bevacizumab depot for uncontrolled glaucoma with ≥ 2 years follow-up were reviewed. The underlying etiology, intraocular pressure (IOP), best-corrected visual acuity (BCVA), and number of anti-glaucoma medications (AGM) were recorded at baseline. Postoperatively, BCVA, IOP, AGMs, complications, and re-surgery were noted on day 1, 1-week, 1-, 3-, 6- months, 1-, 2-, 3-, 4-, 5-years and at final follow-up after 24 months. The main outcomes measured were IOP, number of AGM, and cumulative probability of overall success after 2 years.

Forty-three eyes of 43 patients with a mean age of 54.79 ± 17.27 years were included. The mean follow-up was 62.9 ± 27.42 (24-108) months. The mean pre-operative IOP was 29.23 ± 10.09 mmHg with an average of 4.3 ± 1.2 AGM. The mean IOP and number of AGM were significantly reduced in all follow-up visits (p < .0001) following surgery. The complete success was 48.8% and 48.5% at 2-year and 5-year respectively. The cumulative probability of overall success was 95%, 85%, 80%, and 71% at 2-5-, 7-, and 9-years respectively. A total of 24 complications were noted in 15 eyes in early postoperative days, and all were managed conservatively. The failure was noticed in 6 (17.2%) eyes at 5-year study visits.

The use of ologen implant as a drug depot for bevacizumab in trabeculectomy was safe and had a good long-term outcome.