Safety and Efficacy of Extracellular Matrix Combined With Sutureless Scleral Tunnel Implantation of Mini-Shunt in Glaucoma Surgery
To evaluate the safety and efficacy of using Olagen collagen matrix combined with sutureless scleral tunnel implantation of the Express minishunt in glaucoma surgery.
A retrospective case series of 18 cases in which a sutureless scleral tunnel was used for express mini-shunt implantation was evaluated. All cases were done in conjunction with placement of Olagen collagen matrix over the sceral tunnel and subconjunctival injection of mitomycin C. Consecutive patients with at one least 6 months of follow-up were included in the series. Inclusion criteria were diagnosis of glaucoma with the active use of at least one glaucoma medications with a desired target IOP less than 20 mm Hg. The primary endpoint measure was IOP at 6 months. Secondary measures were hypotony, refractive error, visual acuity, other complications, postoperative inflammation and use of post-operative medications.
Sixteen of 18 Patients who underwent sutureless scleral tunnel placement of the express minishunt in conjunction with olagen and mitomycin C a significant reduction in IOP from baseline (mean IOP reduction= 10.7 mm Hg, p= 0.01). Mean reduction in glaucoma medications was 2.1 medications. The use of the sutureless scleral tunnel appeared to have no impact on refractive error. One patient experienced prolonged hypotony with choroidal effusions.
The technique of using a sutureless scleral tunnel in conjunction with Olagen and subconjunctival MMC appears to be an effective and safe method of performing Express minishunt surgery. When performed properly, this technique appears to result in minimal hypotony and induced refractive error.