Ologen Implant Application in Subscleral Trabeculectomy versus Non-Penetrating Deep Sclerectomy in Management of Primary Open Angle Glaucoma: A Prospective Randomized Study

Abstract

Background: trabeculectomy and deep sclerectomy (DS) aim to lower intraocular pressure (IOP) in cases of medically uncontrolled primary open angle glaucoma (POAG). The application of Ologen implant is thought to increase the success rate of both procedures. Objective: to compare the application of Ologen implant in trabeculectomy versus deep sclerectomy in patients with uncontrolled POAG. Patients and Methods: this was a follow-up randomized clinical comparative trial included 30 eyes of 26 patients with uncontrolled POAG. They were randomly assigned to two equal groups (n=15 eyes): group (A) underwent trabeculectomy and group (B) underwent deep sclerectomy. Both procedures were augmented with Ologen implant. All patients were subjected to full history taking and complete ophthalmologic examination. Postoperatively, patients were followed up at 6 months. Outcome and complications were assessed. Results: both groups experienced significant reduction in IOP after 6 months postoperative; preoperative and postoperative values were 22.8±3.73 mmHg and 11.07±2.63 mmHg, respectively in group (A) and 20.13±2.26 mmHg and 13.53±2.61 mmHg, respectively in group B, P≤ 0.01. The complete success was 93.0% in group (A) and 80.0% in group (B), (P= 0.475). Group (A) had significantly higher frequency of postoperative complications compared to group B (P≤ 0.01). Conclusion: the application of Ologen implant in both trabeculectomy and deep sclerectomy is effective for IOP reduction and it resulted in better operative success in patients with POAG. Also, deep sclerectomy using Ologen implant is a good and safe alternative to trabeculectomy in patients with POAG, but our obtained results need to be supported by subsequent studies.