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Peer-reviewedCC BY-NC-ND 4.0Turkish Journal of Ophthalmology

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

  • Luisa Castro-Roger1
  • Sara Labay-Tejado2
  • Xavier Suárez3
  • Joan Lop Gros4
  • Elena Milla5
5 affiliations
  1. 1St Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom
  2. 2Institut Català de Retina, Barcelona, Spain
  3. 3Admiravision, Department of Ophthalmology, Barcelona, Spain
  4. 4Biomedical Diagnostic Center, Hospital Clínic de Barcelona/Universitat de Barcelona, Department of Surgical Pathology, Barcelona, Spain
  5. 5Hospital Clínic de Barcelona/Universitat de Barcelona, Department of Ophthalmology, Barcelona, Spain
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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.

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Cite

BibTeXRIS
BibTeX
@article{castroroger2026anatomopathological,
  title = {{Anatomopathological Aspects and Clinical Correlation of Conjunctival Bleb Fibrosis Following Encapsulation of a Biodegradable Collagen Matrix Implant in Glaucoma Surgery}},
  author = {Luisa Castro-Roger and Sara Labay-Tejado and Xavier Suárez and Joan Lop Gros and Elena Milla},
  journal = {Turkish Journal of Ophthalmology},
  year = {2026},
  month = oct,
  doi = {10.4274/tjo.galenos.2026.26895},
  url = {https://doi.org/10.4274/tjo.galenos.2026.26895},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Anatomopathological Aspects and Clinical Correlation of Conjunctival Bleb Fibrosis Following Encapsulation of a Biodegradable Collagen Matrix Implant in Glaucoma Surgery
AU  - Luisa Castro-Roger
AU  - Sara Labay-Tejado
AU  - Xavier Suárez
AU  - Joan Lop Gros
AU  - Elena Milla
PY  - 2026
DA  - 2026/10/01
JO  - Turkish Journal of Ophthalmology
DO  - 10.4274/tjo.galenos.2026.26895
UR  - https://doi.org/10.4274/tjo.galenos.2026.26895
AB  - 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.
SN  - 2149-8695
SN  - 2149-8709
ER  -