{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:40:28Z","timestamp":1787071228282,"version":"build-2736575974"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"\n Purpose:<\/jats:title>\n To evaluate the safety and efficacy of a collagen matrix implant (CMI) as an adjunct in ocular surface reconstruction for moderate to severe post\u2010chemical injury symblepharon.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This prospective interventional pilot study included ten eyes of nine patients (all male, mean age 17.90 \u00b1 9.48 years) with moderate (\n n<\/jats:italic>\n = 4) or severe (\n n<\/jats:italic>\n = 6) symblepharon secondary to chemical injury. All patients underwent symblepharon lysis, followed by ocular surface reconstruction using mucous membrane graft and amniotic membrane graft, with the additional placement of a CMI secured with 6\u20100 vicryl sutures. A symblepharon ring was placed postoperatively for 6\u20138 weeks. All patients were followed for at least 6 months. Surgical success was defined as \u226530% forniceal depth (FD) correction at 3 months, categorized as excellent (75 \u2212 100%), good (60 to <75%), or poor (30 to <60%). Recurrence was defined as a >2 mm decrease in FD from the 3\u2010month value. Statistical analysis was performed using SPSS v23.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n All nine patients completed 6 months of follow\u2010up. There was no case of failure or recurrence. The mean percent depth correction at 3 months was 78.32% in the upper eyelid and 74.47% in the lower eyelid. The mean upper middle FD increased significantly from 4.40 mm preoperatively to 12.20 mm at 3 months, stabilizing at 11.40 mm at 6 months. Similarly, the mean lower middle FD improved from 2.42 mm to 7.57 mm at 3 months, maintaining 7.28 mm at 6 months (Friedman test: \u03c7\n 2<\/jats:sup>\n = 10.78,\n P<\/jats:italic>\n = 0.00455). Anatomical outcomes were excellent in 8 eyes, good in 1 eye, and poor in 1 eye. Two patients showed significant visual acuity improvement. One patient developed postoperative orbital cellulitis, and three had pyogenic granuloma (not implant\u2010related). There were no cases of implant extrusion.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The collagen matrix implant appears to be a safe and effective adjunct for ocular surface reconstruction in moderate to severe post\u2010chemical injury symblepharon, demonstrating encouraging short\u2010term anatomical outcomes with no recurrences at 6 months. Further studies with longer follow\u2010up are warranted.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijo.ijo_1933_25","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:00:20Z","timestamp":1774519220000},"page":"580-583","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Ocular surface reconstruction using collagen matrix implant in cases of moderate to severe symblepharon: A pilot study"],"prefix":"10.4103","volume":"74","author":[{"given":"S","family":"Kavya","sequence":"first","affiliation":[{"name":"Department of Oculoplasty and Ocular Oncology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachna","family":"Meel","sequence":"additional","affiliation":[{"name":"Department of Oculoplasty and Ocular Oncology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Vanathi","sequence":"additional","affiliation":[{"name":"Department of Cornea, Lens, Refractive Surgery, Low Vision Aids and Ocular Oncology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelam","family":"Pushker","sequence":"additional","affiliation":[{"name":"Department of Oculoplasty and Ocular Oncology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandeep S","family":"Bajaj","sequence":"additional","affiliation":[{"name":"Department of Oculoplasty and Ocular Oncology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"R1-20260416","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/0142-9612(96)85567-0","article-title":"Recent advances in tissue synthesis in vivo by use of collagen-glycosaminoglycan copolymers","volume":"17","author":"Ellis","year":"1996","journal-title":"Biomaterials"},{"key":"R2-20260416","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1186\/s12886-015-0130-z","article-title":"Biodegradable collagen matrix (Ologen\u2122) implant and conjunctival autograft for scleral necrosis after pterygium excision: Two case reports","volume":"15","author":"Cho","year":"2015","journal-title":"BMC Ophthalmol"},{"key":"R3-20260416","doi-asserted-by":"crossref","first-page":"882092","DOI":"10.1155\/2021\/8820926","article-title":"Evaluation of conjunctival autografting augmented with mitomycin C application versus ologen implantation in the surgical treatment of recurrent pterygium","volume":"2021","author":"Wagdy","year":"2021","journal-title":"J Ophthalmol"},{"key":"R4-20260416","doi-asserted-by":"crossref","first-page":"e85782","DOI":"10.1371\/journal.pone.0085782","article-title":"Ologen implant versus mitomycin C for trabeculectomy: A systematic review and meta-analysis","volume":"9","author":"He","year":"2014","journal-title":"PLoS One"},{"key":"R5-20260416","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1186\/s12886-015-0130-z","article-title":"Biodegradable collagen matrix (Ologen\u2122) implant and conjunctival autograft for scleral necrosis after pterygium excision: Two case reports","volume":"15","author":"Cho","year":"2015","journal-title":"BMC Ophthalmol"},{"key":"R6-20260416","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1080\/09273948.2018.1424340","article-title":"Conjunctival flap with biodegradable collagen matrix implantation for the treatment of scleromalacia after periocular surgery","volume":"27","author":"Han","year":"2019","journal-title":"Ocul Immunol Inflamm"},{"key":"R7-20260416","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1159\/000456719","article-title":"Trabeculectomy with ologen versus mitomycin C in juvenile open-angle glaucoma: A 1-year study","volume":"57","author":"El-Sayyad","year":"2017","journal-title":"Ophthalmic Res"},{"key":"R8-20260416","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.ajo.2008.03.028","article-title":"Surgical strategies for fornix reconstruction based on symblepharon severity","volume":"146","author":"Kheirkhah","year":"2008","journal-title":"Am J Ophthalmol"},{"key":"R9-20260416","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/ICO.0b013e318247983d","article-title":"A combined approach of amniotic membrane and oral mucosa transplantation for fornix reconstruction in severe symblepharon","volume":"32","author":"Kheirkhah","year":"2013","journal-title":"Cornea"},{"key":"R10-20260416","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1007\/s00417-005-0010-y","article-title":"Mitomycin C, amniotic membrane transplantation and limbal conjunctival autograft for treating multirecurrent pterygia with symblepharon and motility restriction","volume":"244","author":"Yao","year":"2006","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"R11-20260416","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1097\/ICO.0000000000003437","article-title":"Impact of symblepharon management with ocular surface reconstruction on scleral lens fitting in eyes with chronic cicatrizing conjunctivitis and keratopathy","volume":"43","author":"Chaudhary","year":"2024","journal-title":"Cornea"},{"key":"R12-20260416","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/j.ajo.2015.06.003","article-title":"Sealing of the gap between the conjunctiva and tenon capsule to improve symblepharon surgery","volume":"160","author":"Zhao","year":"2015","journal-title":"Am J Ophthalmol"},{"key":"R13-20260416","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1097\/ICO.0000000000000423","article-title":"Ocular surface reconstruction with keratolimbal allograft for the treatment of severe or recurrent symblepharon","volume":"34","author":"Farid","year":"2015","journal-title":"Cornea"},{"key":"R14-20260416","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1046\/j.1524-475X.1994.20407.x","article-title":"Specific effects of glycosaminoglycans in an analog of extracellular matrix that delays wound contraction and induces regeneration","volume":"2","author":"Shafritz","year":"1994","journal-title":"Wound Repair Regen"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_1933_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:43:22Z","timestamp":1787067802000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_1933_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,26]]},"references-count":14,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_1933_25","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,26]]},"assertion":[{"value":"2025-08-03","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-22","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}