Long-term follow-up of trabeculectomy with intraoperative 5-fluorouracil for uveitis-related glaucoma

Towler, Hamish M. A.; McCluskey, Peter; Shaer, Boaz; Lightman, Susan

doi:10.1016/s0161-6420(00)00351-1

Cited by 103 publications

(64 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The results of filtering surgery, even with a draining device and antiproliferative agents, vary greatly, and the failure rate is higher for uveitic than non-uveitic glaucoma. [1][2][3] Ten years ago, deep sclerectomy (DS), a non-penetrating surgical operation, was designed to lower the incidence of complications after trabeculectomy (TRAB). 4 DS consists of the physical removal of the resisting element without endangering the eye's structural integrity.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Deep sclerectomy and trabeculectomy in uveitic glaucoma

Dupas

Fardeau

Cassoux

et al. 2009

Eye

View full text Add to dashboard Cite

Purpose To compare the results of deep sclerectomy (DS) and trabeculectomy (TRAB) in the management of uveitic glaucoma. Methods A retrospective chart review was carried out of 41 eyes (38 patients) operated on for uncontrolled uveitic glaucoma, 20 by DS with an implant and 21 by TRAB, with antiproliferative agents in both cases. Main outcome criteria were intraocular pressure (IOP), flare values, complications, and need for postoperative adjustments or re-operation. Results Mean follow-up lasted 21.1±11.3 months in the TRAB group and 18.9 ± 10.7 months in the DS group (P ¼ 0.184). Mean IOP did not differ significantly in the two groups on the day before surgery, at postoperative days 1 and 7, or at months 1, 6, and 12. At postoperative month 12, IOP values in the TRAB and DS groups were 12.4±4.3 and 11.7±3.3 mm Hg (P ¼ 0.688), respectively. The cumulative probability of success at 12 months was 89% for TRAB and 88% for DS (P ¼ 0.306). After DS, more postoperative adjustments were necessary to lower IOP than after TRAB (85 vs 9.5%, Po0.001), but 7 days after surgery, intraocular inflammation was higher after TRAB (245.8 vs 38.5 ph/ms, Po0.001). Conclusions DS and TRAB afforded equivalent IOP control in uveitic glaucoma. TRAB involved deeper invasion of the eye and resulted in more inflammation during the week after surgery, but successful DS required closer postoperative monitoring and more postoperative adjustments.

show abstract

Section: Introductionmentioning

confidence: 99%

“…Both these types of filtering surgeries (DS and TRAB) have been evaluated in uveitic glaucoma, but separately. 1,2,[8][9][10][11] In this retrospective study, we report the mid-term results of both TRAB and DS with antiproliferative agents, in eyes with uveitic glaucoma.…”

Section: Introductionmentioning

confidence: 99%

Deep sclerectomy and trabeculectomy in uveitic glaucoma

Dupas

Fardeau

Cassoux

et al. 2009

Eye

View full text Add to dashboard Cite

show abstract

“…Most studies suggest using antiproliferative agents in terms of long-term IOP control in those patients. 4,6 Stavrou and Murray 18 observed a high rate of trabeculectomy survival (53%) after 5 years without antiproliferatives. A higher success rate (67%) at 5 years was obtained by Towler et al 6 by using intraoperative 5-fluorouracil.…”

Section: Introductionmentioning

confidence: 99%

Ahmed valve implantation in glaucoma secondary to chronic uveitis

Özdal

Vianna

Deschênes

2005

Eye

View full text Add to dashboard Cite

Ahmed valve implantation in glaucoma secondary to chronic uveitis PÇ Ö zdal, RNG Vianna and J Deschê nes AbstractPurpose To evaluate the efficacy of Ahmed valve (AV) implantation in patients with uveitic glaucoma. Methods In total, 18 patients (19 eyes) with glaucoma secondary to chronic uveitis, who underwent AV implantation were retrospectively reviewed. Visual acuity, intraocular pressure (IOP), and glaucoma medications at the most recent examination prior to surgery, were compared with those of last postoperative examination. The surgical success was defined as IOP less than 21 mmHg and greater than 4 mmHg without loss of light perception and visually devastating complications at the last postoperative examination. Decrease in the number of glaucoma medications was also a criterion for surgical success. Results The mean follow-up period was 2679.7 months. The mean preoperative and postoperative IOPs were 33.379.7 (range, 20-57) mmHg and 17.3710.8 (range, 6-40) mmHg respectively (Po0.0001). The mean number of antiglaucoma medications was 3.570.8 (range, 2-5) preoperatively and 1.471.3 (range, 0-4) postoperatively (Po0.0001). Valve occlusion (five eyes, 26.3%) was the most commonly observed complication. Surgical success was achieved in 13 eyes (68.4%). The cumulative probability of success was 94.4% at 1 year and 60% at 2 years. Five eyes (26.3%) with IOP greater than 21 mmHg and one (5.3%) with corneal decompensation requiring penetrating keratoplasty were considered as failures. Conclusions The implantation of AV is an effective surgical procedure for the management of uveitic glaucoma. The inflammatory background might contribute to the occurrence of valve occlusion, which is the most common complication. Prevention of this complication is an essential factor for improving the surgical outcome.

show abstract

“…They determined success rates of 82 and 67%, 2 and 5 years after surgery. 113 Because of corneal epithelial toxicity and the need for frequent postoperative subconjunctival injections, 5-FU has been largely replaced by topical application of mitomycin-C, with good surgical results. In general, in high-risk glaucoma surgery, MMC lowers IOP more than 5-FU and may do so for a longer duration.…”

Section: Trabeculectomymentioning

confidence: 99%

Uveitis and Glaucoma: A Critical Review

Mahajan¹,

Venkatesh²,

Garg³

2011

JOCGP

View full text Add to dashboard Cite

Raised intraocular pressure is a frequently encountered complication of uveitis. Intraocular homeostasis, maintained by the impermeable blood-ocular barrier, is important to guarantee optimal visual function. During uveitis breakdown of the blood-ocular barrier occurs, allowing the influx of proteins as well as inflammatory and immunocompetent cells. The combination of action of inflammatory cells and the mediators they release; and the chronic corticosteroid therapy used to treat the uveitis can participate in the pathogenesis of uveitic glaucoma. These factors alter the normal anatomic structure of the anterior chamber and angle. Management of uveitic glaucoma may be difficult because of the numerous mechanisms involved in its pathogenesis and is guided by careful delineation of the pathophysiology involved in each individual case. This article reviews, in detail, the pathogenesis of uveitic glaucoma and its therapies, with emphasis on the recent developments in the subject.

show abstract

Long-term follow-up of trabeculectomy with intraoperative 5-fluorouracil for uveitis-related glaucoma

Cited by 103 publications

References 23 publications

Deep sclerectomy and trabeculectomy in uveitic glaucoma

Deep sclerectomy and trabeculectomy in uveitic glaucoma

Ahmed valve implantation in glaucoma secondary to chronic uveitis

Uveitis and Glaucoma: A Critical Review

Contact Info

Product

Resources

About