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Collagen device useful for refractory glaucoma
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SAN FRANCISCO — A collagen device designed to treat glaucoma may be an effective alternative to surgical treatment of refractory glaucoma, according to a presentation made here at the American Society of Cataract and Refractive Surgery meeting.
Svetlana Y. Anisimova, MD, discussed potential applications for a new, elastic porous implant of xeno-collagen (type 1) with sulfated glycosaminoglycanes she said can exist in the intrascleral space for several years. In her study, Dr. Anisimova examined 72 eyes of 62 patients with refractory glaucoma. One group had undergone non-penetrating surgery and the other group had undergone angle-uveal insertion of the collagen device. The mean IOP for both groups was 28.5 mm Hg and the patients averaged two medications a day before surgery. A total of 32 eyes had previously undergone different filtering and laser procedures.
None of the patients in either group had postop inflammatory responses, Dr. Anisimova said. Postoperatively, after 3 years of follow-up, 85% of the patients had IOP no higher than 21 mm Hg, with the mean being 16.7 mm Hg. The average amount of medication 21 patients was on dropped to an average of one to two. In 17 cases, YAG laser was performed between 1 and 3 years after initial surgery.
“There was no fibrosis around the implant, and good poral structure," Dr. Anisimova said. "The effect was very good in all cases.”
Dr. Anisimova also said the implant can be used during penetrating procedures as inert and effective drainage.
“The aim is not only to open Schlemm’s canal, but to keep the intrascleral space for years after surgery,” Dr. Anisomova said.