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1 General aspects (0)   1.1 Epidemiology (15)   1.2 Population genetics (0)   1.3 Pathogenesis (0)   1.4 Quality of life (19)   1.5 Glaucomas as cause of blindness (12)   1.6 Prevention and screening (11) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (11)   2.2 Cornea (16)   2.3 Sclera (8)   2.4 Anterior chamber angle (2)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (6)     2.5.2 Schlemms canal (3)     2.5.3 Scleral outlet channels (2)   2.6 Aqueous humor dynamics (0)     2.6.1 Production (0)     2.6.2 Outflow (0)       2.6.2.1 Trabecular meshwork (3)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (1)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (5)   2.9 Ciliary body (3)   2.10 Lens (0)   2.11 Vitreous body (1)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (9)   2.13 Retina and retinal nerve fibre layer (25)   2.14 Optic disc (26)   2.15 Optic nerve (3)   2.16 Chiasma and retrochiasmal central nervous system (6)   2.17 Stem cells (5)   2.20 Other (1) 3 Laboratory methods (0)   3.1 Microscopy (2)   3.2 Electron microscopy (0)   3.3 Immunohistochemistry (0)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (0)     3.4.2 Gene studies (22)   3.5 Molecular biology incl. 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Miscellaneous (34)

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Abstract #79234 Published in IGR 20-1

Efficacy of glaucoma drainage devices in uveitic glaucoma and a meta-analysis of the literature

Ramdas WD; Pals J; Rothova A; Wolfs RCW
Graefe's Archive for Clinical and Experimental Ophthalmology 2019; 257: 143-151

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PURPOSE: To assess the efficacy of glaucoma drainage devices (GDD) in uveitic glaucoma and non-uveitic glaucoma, and to perform a meta-analysis of previously published results to compare with our data. METHODS: Retrospective case-control study, in which all eyes that underwent GDD surgery were included from 2015 onwards. Cases were defined as patients with uveitic glaucoma. Patients with non-uveitic glaucoma served as controls. To compare our results, a review of the literature was performed using PubMed database. RESULTS: A total of 99 eyes were included (38 with uveitic glaucoma). The preoperative IOP was 25.9 ± 7.7 mmHg and 27.9 ± 9.6 mmHg for patients with and without uveitis (p = 0.277). No significant differences were found between patients with and without uveitis in the final IOP or reduction in IOP (44.9% vs. 42.8%, respectively). Within the first year after surgery, 13.2% of cases developed macular edema (vs. 6.6%; p = 0.267) and 15.8% a transient hypotony (vs. 8.2%; p = 0.242). A meta-analysis of 24 studies showed a postoperative weighted mean difference of - 17.8 mmHg and 2.2 lower number of IOP-lowering medications in uveitic glaucoma (compared to - 13.2 mmHg and 3.5 in the current study, respectively). CONCLUSION: GDD surgery in patients with uveitis has a similar effect on IOP as in patients without uveitis. The risks of developing macular edema and hypotony were slightly higher in patients with uveitis, but the results were not statistically significant. These findings are in line with previous reports, though data on the efficacy of GDD surgery and macular edema in uveitic glaucoma is scarce.

Department of Ophthalmology, Erasmus Medical Center, 's Gravendijkwal 230, 3000 CA, Rotterdam, The Netherlands. w.ramdas@erasmusmc.nl.

Full article

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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)
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)

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