Protective effects of biodegradable collagen implants on thinned sclera after strabismus surgery: a paired-eye study.

Abstract

PURPOSE:

To determine the efficacy of a biodegradable Ologen (Aeon Astron Europe BV, Leiden, The Netherlands) collagen matrix in reducing the blue color change due to exposed thinned sclera after strabismus surgery.

METHODS:

Fourteen patients with intermittent exotropia undergoing symmetric bilateral lateral rectus recession surgery were included in this prospective, randomized, paired-eye controlled study. In each patient, Ologen was implanted at the original rectus insertion site in one randomly selected eye; the other eye underwent conventional surgery. Ologen was inserted under the conjunctiva without suturing, covering the muscle insertion site. Conjunctival color change was analyzed using computer-based image analysis immediately and 1 week, 1 month, and 3 months postoperatively. Slit-lamp photographs of each eye were evaluated using contrast limited adaptive histogram equalization (CLAHE), Canny edge, and the RGB (red-green-blue) model. Secondary outcomes were conjunctival and sclera thickness 3 months postoperatively determined by anterior segment optical coherence tomography.

RESULTS:

Immediately and 1 week postoperatively all color models showed no significant differences between Ologen-implanted and control eyes. Three months postoperatively, Ologen-implanted eyes exhibited significantly lower CLAHE (P = 0.041) and RGB model blue color (P = 0.008) values than control eyes. Canny edge (P = 0.061) and RGB model red color (P = 0.152) values did not differ between eyes. Conjunctival stroma and episcleral complex thickness was greater in Ologen-implanted eyes than in controls (P = 0.001).

CONCLUSIONS:

Blue color change was significantly less noticeable in Ologen-implanted eyes than in controls. Thus, Ologen implantation helps prevent visible blue sclera at the original rectus insertion site after lateral rectus recession.

• Authors: Tae Keun Yoo, Sueng-Han Han, Jinu Han
• Journal: Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus (J AAPOS) Vol. 21 Issue 6 Pg. 467-471.e1 (Dec 2017) ISSN: 1528-3933 [Electronic] United States
• PMID: 29102674 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Chemical References

• Glycosaminoglycans
• collagen-glycosaminoglycan copolymer
• Collagen

Topics

• Absorbable Implants
• Adolescent
• Adult
• Child
• Collagen (therapeutic use)
• Exotropia (surgery)
• Female
• Follow-Up Studies
• Glycosaminoglycans (therapeutic use)
• Humans
• Intraocular Pressure
• Male
• Oculomotor Muscles (surgery)
• Ophthalmologic Surgical Procedures (adverse effects)
• Prospective Studies
• Prosthesis Implantation
• Scleral Diseases (etiology, prevention & control)
• Slit Lamp
• Surveys and Questionnaires
• Tomography, Optical Coherence
• Young Adult