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Use of a Collagen Matrix Implant as an Adjuvant in Combined Surgery Involving Phacoemulsification and Nonpenetrating Deep Sclerectomy

Paletta Guedes, Ricardo A., MD, MPH, PhD*,†; Gravina, Daniela M., MD*; Paletta Guedes, Vanessa M., MD*; Chaoubah, Alfredo, PhD

doi: 10.1097/IJG.0000000000001191
Original Studies

Aim: To assess the efficacy and safety of the Ologen collagen matrix as an adjuvant for combined phacoemulsification and nonpenetrating deep sclerectomy (Phaco-NPDS), in addition to mitomycin C (MMC).

Materials and Methods: This was a longitudinal retrospective comparative study of eyes treated with Phaco-NPDS, with (group 1) or without (group 2) an Ologen collagen matrix implant, in addition to MMC. The main outcome measures were operative success [absolute success: intraocular pressure (IOP) <18 mm Hg and an at least 20% reduction from baseline without medication; relative success: IOP<18 mm Hg and at least 20% reduction from baseline IOP with or without medication], mean reductions (%) in IOP and medication use; number of postoperative reinterventions (goniopuncture, needling, reoperation), and number of complications.

Results: The mean age of the study population (N=100) was 72.0±9.7 years. Groups 1 (n=51) and 2 (n=49) achieved absolute success rates of 72.5% and 55.1%, respectively (P=0.054), and relative success rates of 90.2% and 83.7%, respectively (P=0.251). From a similar baseline IOP (19.8 and 20.7 mm Hg in groups 1 and 2, respectively, P=0.527), eyes in group 1 achieved a significant lower 12-month IOP (11.7 vs. 14.5 mm Hg, respectively, P=0.002) and a lower rate of medication use (0.2 vs. 0.9, respectively, P<0.001). Eyes in group 2 presented with a higher rate of bleb failure (12.2% vs. 2.0%, P=0.028), leading to a higher rate of needling procedures (38.8% vs. 2.0%, P<0.001) during the postoperative period.

Conclusions: The adjunctive use of Ologen collagen matrix in addition to MMC during Phaco-NPDS was associated with a higher rate of absolute success, a lower mean IOP at 12 months, a lower rate of bleb failure, and a lower rate of postoperative bleb needling.

*Paletta Guedes Eye Institute

Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil

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Disclosure: The authors declare no conflict of interest.

Reprints: Ricardo A. Paletta Guedes, MD, MPH, PhD, 79 Oscar Vidal Street, Juiz de Fora 36010-060, Minas Gerais, Brazil (e-mail:

Received October 11, 2018

Accepted December 21, 2018

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