PMC5892321_01
Case 1. Before ologen implantation, slit-lamp examination shows the exposed Baerveldt tube OD (a). The ologen Collagen Matrix is placed on the tube (b) and the conjunctiva is closed (c). Two years later, slit-lamp examination shows that the tube is not exposed (d); dense conjunctival tissue is seen over the tube by transverse (e) and cross-sectional (f) images of the tube using AS-OCT.
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F1
Slit-lamp examination showed the exposed tube between the posterior edge of the autologous scleral flap and the anterior edge of the plate (Fig. 1a). He underwent surgery to cover the tube with the surrounding conjunctiva combined with subconjunctival placement of an ologen Collagen Matrix (model 862051, 12 mm in diameter x 1 mm thick) as a patch graft (Fig. 1b, c). At the final visit 2 years later, the BCVA and IOP were 0.15 and 9 mm Hg, respectively, without antiglaucoma medications, and the tube was not exposed (Fig. 1d). At this time, anterior-segment optical coherence tomography (AS-OCT) showed dense conjunctival tissue over the tube (Fig. 1e, f).
PMC5892321_02
Case 2. At the initial visit, peripheral corneal infiltrates and anterior scleritis are seen OD (a). During implantation of the Ahmed glaucoma valve, the tube is not covered fully by the partial autologous scleral flap (b, arrow). The ologen Collagen Matrix is placed on the tube as a patch graft (c) and the conjunctiva is re-adapted. Seventeen months after the ologen implantation, the position of the tube is excellent (arrow) and the tube is not exposed (d).
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F2
Slit-lamp examination showed peripheral corneal infiltrates and ciliary injections OD (Fig. 2a). Intraoperatively, the tube was not covered fully by the autologous scleral flap due to scleritis-related scleral thinning (Fig. 2b); an ologen Collagen Matrix (model 862051) was placed above the scleral flap as a patch graft (Fig. 2c). At the final visit 17 months after the ologen implantation, the BCVA and IOP were 0.3 and 9 mm Hg, respectively, without antiglaucoma medications, and the tube was not exposed (Fig. 2d).
PMC5892321_03
Case 2. During implantation of an Ahmed glaucoma valve, the tube is not fully covered by a partial autologous scleral flap (a, arrow). The ologen Collagen Matrix is placed on the tube as a patch graft (b) and the conjunctiva is re-adapted. Two days postoperatively, round material is seen under the conjunctiva (c, arrowheads). Two months postoperatively, the material has not been identified (d). Three weeks postoperatively, AS-OCT shows thick subconjunctival tissue over the tube (e, arrow).
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F3
Intraoperatively, the tube was not covered fully by the autologous scleral flap because of a flap defect (Fig. 3a). An ologen Collagen Matrix (model 862051) was placed over the scleral flap as a patch graft (Fig. 3b). Two days postoperatively, a slit-lamp examination showed round material under the conjunctiva (Fig 3c, arrowheads) that became unidentified 2 months postoperatively (Fig. 3d). AS-OCT showed thick subconjunctival tissue over the tube (Fig. 3e). At the final visit 3 months after ologen implantation, the BCVA and IOP were 0.04 and 7 mm Hg, respectively, without antiglaucoma medications, and the tube was not exposed.