Surgical outcomes of uveitic glaucoma

Abstract

Purpose Secondary glaucoma is a difficult and frequent complication of uveitis. The aim of this study is to describe the results of surgery in uveitic glaucoma and to identify situations linked to a high risk of failure of the surgery. Methods Retrospective observational study. Clinical and surgical data from 27 cases of uveitic glaucoma that underwent glaucoma surgery over a period of 9 years were collected. Results The main diagnosis and aetiology were anterior uveitis (61.90%) and herpes (38.10%) respectively. Trabeculectomy with mitomycin C was performed in 51.9% of the cases. An intraocular pressure lower than 16 mmHg and managed with less than two drugs was achieved in 48.15% of the cases. Higher risks of surgical failure were associated with intermediate uveitis, idiopathic uveitis, Fuchs' cyclitis, combined surgery with phacoemulsification, omission of mitomycin C, intraocular inflammation at surgery and relapse of the uveitis. Conclusions There are some situations linked to a high risk of failure of surgery in uveitic glaucoma, which should be avoided when possible, mainly the association of higher risk with combined approaches.

Surgical outcomes of trabeculectomy and glaucoma drainage implant for uveitic glaucoma and relationship with uveitis activity

“…Trabeculectomy surgery for uveitic glaucoma is known to have worse prognosis compared with surgery for POAG . Overall qualified success rate of 67% for trabeculectomy in our study is comparable with those found in similar studies for uveitic glaucoma (50–85%) . Kaburaki et al showed that in eyes with inactive uveitis, success rate was 65% at 5 years and has higher rate of ocular hypotony after operation compared to POAG .…”

“…Mixed findings were reported in the literature with regard to the effect that activity of uveitis at the time of surgery has on surgical outcomes. A small study with 21 cases of uveitic glaucoma concluded that active uveitis at the time of surgery is a significant risk factor for failure; however, there were only two cases with active uveitis at the time of surgery in that series . In larger studies from Japan by Kaburaki et al and Shimizu et al showed that the presence of inflammation at the time of surgery was not a significant risk factor for the outcome of trabeculectomy but postoperative relapse of inflammation was significant .…”