Anatomopathological Aspects and Clinical Correlation of Conjunctival Bleb Fibrosis Following Encapsulation of a Biodegradable Collagen Matrix Implant in Glaucoma Surgery.

Authors

Luisa Castro-Roger, Sara Labay-Tejado, Xavier Suárez, Joan Lop Gros, Elena Milla

Published in

Turkish journal of ophthalmology. Volume 56. Issue 5. Pages 339-350. Oct 23, 2026.

Abstract

This study reports a case series of glaucoma patients in whom a biodegradable collagen-glycosaminoglycan implant (Ologen^®) failed to prevent fibrosis after non-penetrating deep sclerectomy (NPDS) and describes the associated histopathological findings. This single-centre retrospective study included four patients with progressive glaucoma and inadequate intraocular pressure (IOP) control despite maximal medical therapy. All underwent NPDS with implantation of a collagen-glycosaminoglycan matrix and adjunctive mitomycin C. Postoperative follow-up included IOP monitoring, slit-lamp examination, and photographic documentation. Patients with bleb failure required surgical revision, and excised tissue, including the implant and surrounding Tenon's capsule, was analysed histologically. All cases developed progressive bleb fibrosis. The implants remained intact, encapsulated by dense fibrotic tissue ("ring-of-steel" appearance), with minimal fibroblast infiltration, extensive collagen deposition, and no significant degradation for up to three years. These findings highlight variability in tissue response and suggest a potential role of patient-specific fibrotic predisposition in surgical outcomes.

PMID:
42929100
Bibliographic data and abstract were imported from PubMed on 26 Oct 2026.

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