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Abstract

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Abstract

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Abstract

PURPOSE: To compare the efficacy and safety of trabeculectomy with mitomycin C, performed with versus without adjunctive Ologen collagen matrix in a multicenter real-world setting.
METHODS: This multicenter retrospective comparative study included 277 patients (365 eyes) who underwent trabeculectomy with mitomycin C, with or without Ologen, between 2017 and 2022 across five Brazilian centers. Extracted data comprised demographic characteristics, glaucoma subtype, intraocular pressure, number of glaucoma medications, postoperative interventions, complications, and additional surgical procedures. Surgical success was defined using two criteria: (1) intraocular pressure ≤21mmHg with ≥20% reduction from baseline and (2) final intraocular pressure between 6 and 21mmHg. Outcomes were categorized as complete (without medications) or qualified (with medications).
RESULTS: Both groups achieved substantial reductions in intraocular pressure and medication burden at 12 months, with high rates of complete and qualified success under both definitions. The Ologen group required fewer suture lysis procedures (49.0% vs. 60.8%; p=0.025), suggesting a modulatory effect on early postoperative fibrosis. Rates of other postoperative interventions, complications, and additional glaucoma surgeries were comparable between groups. Kaplan–Meier analysis demonstrated no significant difference in cumulative success over time.
CONCLUSION: Trabeculectomy with mitomycin C is effective and safe regardless of adjunctive Ologen use. Although Ologen did not confer superior long-term efficacy, its association with reduced suture lysis suggests a potential role in modulating early wound healing.

Keywords: Trabeculectomy, Intraocular pressure, Mitomycin C; Wound healing; Sutures

Abstract

PURPOSE: This study aimed to analyze the association between magnetic resonance imaging apparent diffusion coefficient map value and histopathological differentiation in patients who underwent eye enucleation due to retinoblastomas.
METHODS: An observational chart review study of patients with retinoblastoma that had histopathology of the lesion and orbit magnetic resonance imaging with apparent diffusion coefficient analysis at Hospital de Clínicas de Porto Alegre between November 2013 and November 2016 was performed. The histopathology was reviewed after enucleation. To analyze the difference in apparent diffusion coefficient values between the two major histopathological prognostic groups, Student's t-test was used for the two groups. All statistical analyses were performed using SPSS version 19.0 for Microsoft Windows (SPSS, Inc., Chicago, IL, USA). Our institutional review board approved this retrospective study without obtaining informed consent.
RESULTS: Thirteen children were evaluated, and only eight underwent eye enucleation and were included in the analysis. The others were treated with photocoagulation, embolization, radiotherapy, and chemotherapy and were excluded due to the lack of histopathological results. When compared with histopathology, magnetic resonance imaging demonstrated 100% accuracy in retinoblastoma diagnosis. Optic nerve invasion detection on magnetic resonance imaging showed a 66.6% sensitivity and 80.0% specificity. Positive and negative predictive values were 66.6% and 80.0%, respectively, with an accuracy of 75%. In addition, the mean apparent diffusion coefficient of the eight eyes was 0.615 × 10³ mm²/s. The mean apparent diffusion coefficient value of poorly or undifferentiated retinoblastoma and differentiated tumors were 0.520 × 10³ mm²/s and 0.774 × 10³ mm²/s, respectively.
CONCLUSION: This study revealed that magnetic resonance imaging is useful in the diagnosis of retinoblastoma and detection of optic nerve infiltration, with a sensitivity of 66.6% and specificity of 80%. Our results also showed lower apparent diffusion coefficient values in poorly differentiated retinoblastomas with a mean of 0.520 × 10³ mm²/s, whereas in well and moderately differentiated, the mean was 0.774 × 10³ mm²/s.

Keywords: Retinoblastoma; Prognosis; Retinal neoplasms; Orbit; Diffusion magnetic resonance imaging