VT339 : Using Ologen implant in management of hypotonic maculopathy after trabeculectomy.

Dr.Neha Midha, Dr.Dada Tanuj, Dr.SAGNIK SEN, Dr.MRITTIKA SEN

In this video we present 3 cases of hypotonic maculopathy (post Mitomycin- C augmented trabeculectomy) who underwent surgical revision with ologen implant. Case 1 presented with thin walled bleb and underlying full thickness scleral defect on ASOCT. Patient underwent a scleral patch graft with subconjunctival ologen implant and conjunctival advancement. In Case 2 hypotonic maculopathy was associated with overfiltering bleb. On exploration, scleral flap dehiscence was noted. Maumenee’s repair with subconjunctival ologen implantation and conjunctival resuturing was done. In case 3, the underlying sclera was intact as noted on ASOCT, only a leaky thin walled bleb was noted. The bleb tissue was excised and conjunctival advancement with subconjunctival ologen implantation was done. In all 3 cases ologen has a dual action- first to prevent fibrosis and failure of surgery due to repeat intervention and second to act as a tamponade over the scleral flap to allow guarded filtration.