Background: Trabeculectomy is the most frequent form of glaucoma surgery. Despite the intraoperative use of antimetabolites, such as mitomycin C (MMC) postoperative scarring reactions can cause surgical failure. The subconjunctival placement of an Ologen® implant can avoid wound scarring. The additional application of bevacizumab should reduce angiogenesis and thereby scarring reactions and improve the surgical success rate.
Methods: This was a retrospective single center study of patients with glaucoma after trabeculectomy with MMC. The operation was carried out either without an Ologen® implant (group 1), or with an Ologen® implant as an bevacizumab depot (group 2) or with an Ologen® implant and intrachamber injection of bevacizumab (group 3). The follow-up postoperative observation of intraocular pressure (IOP), complications, subsequent interventions and antiglaucoma treatment was performed for 12 months.
Results: There were no significant differences between the groups with respect to IOP, complications, subsequent interventions and postoperative antiglaucoma treatment. The highest success rate (IOP after 12 months ≤15 mm Hg without treatment) was in group 1 (77.5%), followed by group 2 with 63.6% and group 3 with 57.1% (p = 0.34, χ2-test).
Conclusion: The highest success rate was achieved in group 1 with MMC but without an Ologen® implant or bevacizumab. In this study the additional use of Ologen® implants and bevacizumab in trabeculectomy was found to be a safe operation method but did not provide any additional benefits.
Keywords: Anti-VEGF; Collagen matrix implant; Filtration surgery; Glaucoma; Mitomycin C.