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   Table of Contents      
PHOTO ESSAY
Year : 2019  |  Volume : 67  |  Issue : 3  |  Page : 395-396

Intracameral migration of collagen matrix implant


1 Department of Ophthalmology, Pt. BD Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
2 Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
3 Department of Ophthalmology, Kalpana Chawla Government Medical College and Hospital, Karnal, Haryana, India

Date of Submission05-May-2018
Date of Acceptance03-Jan-2019
Date of Web Publication18-Feb-2019

Correspondence Address:
Dr. Sumeet Khanduja
Department of Ophthalmology, Kalpana Chawla Government Medical College and Hospital, Karnal - 132 001, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_754_18

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  Abstract 


Keywords: Blunt trauma after filtration surgery, collagen matrix implant, ologen, trabeculectomy


How to cite this article:
Phogat J, Rathi M, Sachdeva S, Takkar B, Khanduja S. Intracameral migration of collagen matrix implant. Indian J Ophthalmol 2019;67:395-6

How to cite this URL:
Phogat J, Rathi M, Sachdeva S, Takkar B, Khanduja S. Intracameral migration of collagen matrix implant. Indian J Ophthalmol [serial online] 2019 [cited 2019 Dec 7];67:395-6. Available from: http://www.ijo.in/text.asp?2019/67/3/395/252427




  Case Report Top


A 24-year-old male presented with acute loss of vision immediately following blunt trauma to the left eye (LE) 4 h earlier. He had undergone trabeculectomy for steroid induced glaucoma 2 weeks ago. Vision in LE was limited to perception of light only. Intense bulbar conjunctival congestion and chemosis was present with stromal corneal edema in the LE, while a fluffy white foreign body was seen in the anterior chamber [Figure 1]. B-scan ultrasound revealed normal posterior segment to be normal.
Figure 1: (a) Intraoperative picture following conjunctival dissection. Dehiscence of trabeculectomy wound, prolapsed uveal tissue with intracameral Ologen implant. (b) Dense cataract had developed by the sixth week of follow-up

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In view of the available records and nature of trauma, the foreign body was judged to be the collagen matrix implant (CMI) used in filtration surgery before. Urgent wound repair was advised during which a circumferential scleral laceration, 5.5 mm in length, was found along the superior limbus involving the site of the trabeculectomy ostium, causing dehiscence of the scleral flap. The foreign body was removed in toto and wound repaired. Routine postoperative care was advised. Six weeks postoperatively, Intraocular pressure (IOP) was 12 mmHg on topical medication and visual acuity was 4/60, due to cataract [Figure 1]. Subsequently lens aspiration with Intraocular lens (IOL) implantation in capsular bag was performed. Three months later, visual acuity was 20/80, while IOP was 14 mmHg on topical medication.


  Discussion Top


CMI are used as an adjunct to trabeculectomy to prevent surgical site fibrosis.[1],[2],[3] Typically, the size of CMIs is around 6 × 2 mm in diameter, whereas dimension of the sclerostomy site is much less.[4],[5] Hence, spontaneous migration of an intact implant is highly unlikely, though other complications, such as bleb leakage, conjunctival atrophy, implant exposure, and endophthalmitis are known.[2],[3] As CMIs may act as a nidus of infection,[2] these eyes may be at a high risk of infection in the setting of an open globe injury.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Cillino S, Casuccio A, Di Pace F, Cagini C, Ferraro LL, Cillino G. Biodegradable collagen matrix implant versus mitomycin-C in trabeculectomy: Five-year follow-up. BMC Ophthalmol 2016;16:24.  Back to cited text no. 1
    
2.
Gupta S, Wadhwani M, Sehgal V, Sharma S, Dada T. Blebitis with scleral abscess in a case of operated trabeculectomy with mitomycin C and a subconjunctival ologen implant. Eye 2014;28:354-4.  Back to cited text no. 2
    
3.
Siggel R, Dietlein T. Early atrophy of the conjunctiva after trabeculectomy with mitomycin C and collagen matrix implant. Ophthalmologe2018;115:74-6.  Back to cited text no. 3
    
4.
Coote M, Crowston J. Revision trabeculectomy: Pearls and pitfalls. J Curr Glaucoma Pract 2012;6:131-8.  Back to cited text no. 4
    
5.
Rosentreter A, Schild AM, Jordan JF, Krieglstein GK, Dietlein TS. A prospective randomised trial of trabeculectomy using mitomycin C vs an ologen implant in open angle glaucoma. Eye 2010;24:1449-57.  Back to cited text no. 5
    


    Figures

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