Abstract
Purpose :
Ologen has been used in glaucoma filtration procedures to attenuate the scarring response. Ahmed glaucoma implants are known to be associated with early postoperative IOP elevations. Theishypertensive phase usually occurs in the first several months following the implantation of the device. The purpose of this study is to determine the short term IOP control following Ahmed implant surgery when Ologen (aeon astron, The Netherlands) is used as a spacer over the plate.
Methods :
This study is a retrospective chart review of sequential surgeries in adult glaucoma patients.. A data base of glaucoma implant surgery was created from a single surgeon, KCG, from January 2016 to October 2018,to capture cases where Ologen may have been used. Surgical reports of 360 patients are under review. To date, 200 cases have been reviewed and data collected on 53 surgeries from 43 patients who had Ologen implanted over the plate. Demographic data on age, sex and glaucoma diagnosis and post operative problems is collected. Cllinical information on number of pre operative medications and IOP and post operative IOP and medications for the first 90 days, in monthly intevals is collected.
Results :
Age ranged from 22 to 93 years and eyes were 29 female (54.7%) and (45.3%) male. Pre operative diagnosis was primary open angle glaucoma in 29 (55%) surgical cases. Mean pre operative IOP was 28.2mm Hg with a range of 9-55. Mean glaucoma medicatons was 3.4 pre op and 1.5, 2.42 and 2.78 at one, two and three months respectively. IOP mean was 14.5mmHg, 15.28 and 14.2 respectively at one, two and three months. Fifty eyes had follow up at two months and forty-eight at three.
Conclusions :
Compared to a propective study abstract from New York Eye and Ear Infirmary with 15 patients where Ologen was placed over Ahmed FP7 plate during surgery , the IOP decrease is similar to improved in this larger patient set . Mean IOP decreased 51% by one month and was sustained at the three month visit. There was a slight increase in post operative pressure at 2 months a decrease of 54.6% compared to the pre operative IOP. This may represent a mild hypertensive versus earlier studies on Ahmed implant placement with no Ologen. Post operative medications were decreased tweny-eight percent. at the three month time point. Olagen maybe an uselful adjunt to Ahmed implant surgery.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.