October 2016
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24 Reads
Acta Ophthalmologica
Purpose To establish the efficacy and safety of an Ab Interno Collagen Stent (AICS) in combination with subconjunctival Mitomycin C (MMC) in patients with open angle glaucoma (OAG), in the reduction of intraocular pressure (IOP), hypotensive treatment (HT) and progression on structural retinal nerve fiber layer (RNFL) exams. Methods Prospective, non-randomized study involving 10 eyes with OAG, not controlled by HT, submitted to AICS implantation (Xen Gel Stent, Aquesys, Calif., USA) following subconjuntival MMC, with 6 month of follow-up. Patients were reevaluated on the 1st day, 1st week and at 1st, 3rd and 6th months of follow-up. IOP and bubble dimensions were registered and the need for re-interventions or HT was analyzed. Structural RNFL evaluation was performed at 6 months (Spectralis OCT, Heidelberg Engineering, Heidelb., Germany), and compared to preoperative values. Correlation analysis was made between IOP reduction, bubble dimensions and age. Results Mean IOP values were 21.8 ± 5.87 mmHg, 11.4 ± 4.5 mmHg, 13.2 ± 3.93 mmHg; 18.1 ± 6.9 mmHg, 14.2 ± 3.19 mmHg and 13.7 ± 3.10 mmHg and mean bubble dimensions were 3.1; 2.5; 2.5; 2.5 and 2.6 at 1st day, 1st week and 1st, 3rd and 6th months, respectively. Re-interventions were necessary in 4 cases. IOP reductions compared to preoperative values were statistically significant at all follow-up visits (p < 0.05), except for the 1st post-operative month. There was a statistically significant correlation between bubble dimensions and IOP reduction (p < 0.05; r = −0.788). There was no significant progression of RNFL loss. Hypotensive medication was reduced by 87.5%. No complications were reported. Conclusions The insertion of an Ab Interno Collagen Stent with adjunctive MMC significantly reduced IOP over a 6 months follow-up period without significant complications, notwithstanding a considerable need for re-interventions.