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Abstract #18419 Published in IGR 3-3
Long-term surgical outcomes of patients with glaucoma secondary to the iridocorneal endothelial syndrome
Doe EA; Budenz DL; Gedde SJ; Imami NROphthalmology 2001; 108: 1789-1795
PURPOSE: To report the long-term outcomes of patients with iridocorneal endothelial (ICE) syndrome who required surgery for glaucoma. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: Twenty-six patients with ICE syndrome who underwent surgery for glaucoma at one institution between January 1987 and January 2000. MAIN OUTCOME MEASURES: Intraocular pressure (IOP), visual acuity, number of glaucoma medications, and further surgical interventions were measured. RESULTS: Five eyes had a trabeculectomy with an antifibrotic agent alone, seven eyes had trabeculectomy with an antifibrotic agent and a subsequent glaucoma drainage implant (GDI), and 14 eyes had a GDI alone. In eyes that underwent trabeculectomy with an antifibrotic agent, preoperative IOP was reduced from a mean of 38.8 ± 10.5 mmHg on 2.3 ± 0.8 glaucoma medications to a mean of 11.8 ± 4.3 mmHg on 1.2 ± 1.4 medications at the last follow-up after surgery (83.8 ± 40.3 months). In eyes that underwent GDI surgery, preoperative IOP was reduced from a mean of 35.2 ± 13.0 mmHg on 2.0 ± 1.3 glaucoma medications to a mean of 8.7 ± 11.2 mmHg on 1.2 ± 1.1 medications at the last follow-up after surgery (50.5 ± 40.7 months). Twenty-four eyes (92%) had an IOP of less than 22 mmHg, and 22 eyes (85%) had a visual acuity of 20/400 or better at the last follow-up (55.8 ± 41.5 months). Mean number of glaucoma surgeries per patient over the follow-up period was 1.6 ± 1.2. Trabeculectomy with antifibrotic agents had a survival of 73% at one year, 44% at three years, and 29% at five years. Glaucoma drainage implants had a survival of 71% at one year, 71% at three years, and 53% at five years. CONCLUSIONS: Glaucoma associated with ICE syndrome can be managed successfully surgically, although multiple procedures are often needed.
Dr D.L. Budenz, Bascom Palmer Eye Institute, 900 NW 17th Street, Miami, FL 33136, USA. dbudenz@med.miami.edu
Classification:
9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)