advertisement
Abstract #16853 Published in IGR 9-1
Outcome of trabeculectomy with intraoperative mitomycin C for uveitic glaucoma
Noble J; Derzko-Dzulynsky L; Rabinovitch T; Birt CCanadian Journal of Ophthalmology 2007; 42: 89-94
BACKGROUND: The purpose of this study was to compare the outcomes of mitomycin C (MMC)-augmented trabeculectomy in glaucoma patients with uveitis to those without uveitis but with other high-risk characteristics. METHODS: A retrospective comparative cohort analysis consisting of 51 eyes of 51 patients (21 uveitic patients and 30 nonuveitic patients) was performed. Two outcome classifications were analyzed: absolute success (intraocular pressure [IOP] ≤ 30% baseline without glaucoma medications or 5-fluorouracil (5-FU) injections), and qualified success (IOP ≤ 30% baseline with glaucoma medications or 5-FU injections). Kaplan-Meier survival curves were constructed for both models. RESULTS: After a mean follow-up of 52 months, uveitis emerged as a negative predictor of success. In the qualified success model, uveitic patients demonstrated survival rates of 90% at 1 year and 79% at 2 years compared with 100% for all time points in the control group (Wilcoxon test, p = 0.005). Uveitic patients were more likely to require postoperative 5-FU injections than the control group (33% vs. 10%, p = 0.04) and were more likely to require glaucoma medications postoperatively for IOP control (38% vs. 3%, p = 0.001). INTERPRETATION: Uveitic glaucoma patients are more likely to require postoperative therapeutic interventions to maintain adequate pressure control in the short-term and are at higher risk of surgical failure in the long-term.
Classification:
9.4.6 Glaucomas associated with inflammation, uveitis (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
