Prospective Randomized Trial Comparing Mitomycin C Combined with Ologen Implant versus Mitomycin C Alone as Adjuvants in Trabeculectomy Mrittika Sen,

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Prospective Randomized Trial Comparing Mitomycin C Combined with Ologen Implant versus Mitomycin C Alone as Adjuvants in Trabeculectomy Mrittika Sen, MD, Neha Midha, MD, Talvir Sidhu, MD, Dewang Angmo, MD, Ramanjit Sihota, MD, FRCS, Tanuj Dada, MD Ophthalmology Glaucoma Volume 1, Issue 2, Pages 88-98 (September 2018) DOI: 10.1016/j.ogla.2018.07.003 Copyright © 2018 American Academy of Ophthalmology Terms and Conditions

Figure 1 Flowchart showing the enrollment and randomization of patients into 2 study groups, mitomycin C (MMC) alone and MMC plus Ologen, and their follow-up over 12 months. Ophthalmology Glaucoma 2018 1, 88-98DOI: (10.1016/j.ogla.2018.07.003) Copyright © 2018 American Academy of Ophthalmology Terms and Conditions

Figure 2 Bleb parameters measured on anterior segment OCT. The total bleb height is the maximum distance between the internal surface of the suprascleral fluid-filled cavity and the surface of the conjunctival epithelium. The internal fluid-filled cavity is a significantly low-reflective fluid-filled space adjunct to the scleral flap. The bleb wall thickness was measured from the conjunctiva to the top of the suprascleral fluid cavity. Ophthalmology Glaucoma 2018 1, 88-98DOI: (10.1016/j.ogla.2018.07.003) Copyright © 2018 American Academy of Ophthalmology Terms and Conditions

Figure 3 Kaplan-Meier survival curve for eyes achieving (A) absolute success and (B) cumulative success (using the ≤15-mmHg cutoff at 1 year of follow-up). MMC = mitomycin C. Ophthalmology Glaucoma 2018 1, 88-98DOI: (10.1016/j.ogla.2018.07.003) Copyright © 2018 American Academy of Ophthalmology Terms and Conditions

Figure 4 Clinical photographs showing bleb and complications after trabeculectomy surgery. A, Slit-lamp photograph of a bleb after trabeculectomy with low-dose mitomycin C (MMC) at 6 months of follow-up. B, Slit-lamp photograph of a bleb after trabeculectomy with Ologen and low-dose MMC at 6 months of follow-up. C, Slit-lamp photograph showing a patient treated with Ologen with an encapsulated bleb. D, Slit-lamp photograph of a patient treated with Ologen showing a postoperative shallow anterior chamber. Ophthalmology Glaucoma 2018 1, 88-98DOI: (10.1016/j.ogla.2018.07.003) Copyright © 2018 American Academy of Ophthalmology Terms and Conditions

Figure 5 Anterior segment OCT images of the bleb in the mitomycin C (MMC) and Ologen groups. All figures on the left are from the MMC group and those on the right are from Ologen group. A, Well-elevated bleb with cystic spaces in the bleb wall at 1 month after surgery. B, Well-functioning bleb with hyporeflective spaces in the bleb wall at 3 months. C, Bleb at 6 months with multiple hyporeflective spaces. D, Bleb showing a uniform fluid cavity at 1 month after surgery. E, Bleb with patent ostium and microcysts in the bleb wall at 3 months. F, Bleb with homogenous fluid cavity with uniform reflectivity of bleb wall. Ophthalmology Glaucoma 2018 1, 88-98DOI: (10.1016/j.ogla.2018.07.003) Copyright © 2018 American Academy of Ophthalmology Terms and Conditions