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Abstract #3548 Published in IGR 4-2
Trabeculectomy with antiproliferative agents in uveitic glaucoma
Ceballos EM; Beck AD; Lynn MJJournal of Glaucoma 2002; 11: 189-196
PURPOSE: To evaluate the outcome of trabeculectomy with antiproliferative agents in patients with uveitic glaucoma METHODS: A retrospective chart review of 44 eyes of 44 patients with uveitic glaucoma who underwent trabeculectomy with mitomycin C or 5-fluorouracil. The authors defined complete success as an intraocular pressure (IOP) of 21 mmHg or lower without pressure-lowering medications, qualified success as an IOP of 21 mmHg or lower with medications, and failure as an IOP of more than 21 mmHg with medications, loss of light perception, or the need for reoperation. RESULTS: The cumulative probability of complete or qualified success was 78% at one year and 62% at two years. At two years, success rates were 39% in males and 71% in females (p = 0.02), 74% in white patients and 55% in black patients (p = 0.58), and 45% in patients with idiopathic uveitis and 74% in patients with sarcoid uveitis (p = 0.17). Sixteen of 31 (51.6%) phakic patients developed new cataracts or had progression of existing cataracts and required cataract extraction. Four of 16 eyes (25%) lost IOP control and needed repeat trabeculectomy after undergoing cataract surgery. CONCLUSIONS: Patients with uveitic glaucoma can have good outcomes after trabeculectomy with antiproliferative agents. Male gender was the only statistically significant risk factor for trabeculectomy failure. Cataract management in the presence of a filtering bleb poses a treatment dilemma between improvement of visual acuity and loss of IOP control.
Dr. E.M. Ceballos, Department of Ophthalmology, Emory University School of Medicine and Department of Biostatistics, Rollins School of Public Health of Emory University, Atlanta, GA 30322, USA
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)
