Comparing the use of Tutopatch® pericardium with Tutoplast® fascia lata in the context of PAUL® glaucoma implant surgery: an anterior segment OCT study.

AIM

To evaluate the use of high-resolution anterior segment optical coherence tomography (AS-OCT) for the comparison of different patch grafts and their changes in patients undergoing PAUL® Glaucoma Implant (PGI) surgery.

METHODS

Prospective analysis over twelve months of pericardium and fascia lata patch graft thickness of PGI surgical cases at the University Eye Hospital Bonn, Germany, from November 2021 to March 2023. In all eyes, either Tutopatch® pericardium or Tutoplast® fascia lata was used to cover the implant intra-operatively. AS-OCT examinations were performed to measure quantitative and qualitative aspects of the patch grafts before surgery, and at three, six, and twelve months after surgery.

RESULTS

50 eyes of 47 patients were included. For Tutopatch® (26 eyes) the patch material thickness directly over the tube decreased from an initial 1020 ± 302 µm to 564 ± 458 µm at twelve months after surgery whereas for Tutoplast® (24 eyes) it decreased from an initial 1575 ± 319 µm to 1380 ± 317 µm at twelve months. Tutopatch® material declined faster by -42.1 µm/month (CI: -57.2--26.9, p < 0.001). Five patients in the Tutopatch® group showed tube erosion whereas none did in the Tutoplast® group. Adjusting for potential confounding variables did not substantially alter the association between the groups and patch material thickness.

CONCLUSIONS

This study shows that AS-OCT is a useful method for comparing different patch materials after PGI surgery. When comparing pericardium with fascia lata, the latter evidenced a slower rate of thickness reduction and was associated with less tube exposure.