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Abstract #99321 Published in IGR 22-4
Characteristics and outcomes of glaucoma associated with congenital ectropion uvea
Jacobson A; Moroi SE; Bohnsack BLAmerican Journal of Ophthalmology 2022; 241: 1-8
PURPOSE: Determine visual outcomes and effectiveness of glaucoma surgeries in congenital ectropion uvea. DESIGN: Retrospective interventional case series METHODS: Surgeries and exam findings were collected on 11 eyes of 8 patients with congenital ectropion uvea at 2 academic sites from 2001-2021. Visual outcomes, surgical success (IOP 5-20 mmHg, no additional IOP-lowering surgery, no visually devastating complications), and survival rates of glaucoma surgeries were assessed. RESULTS: Glaucoma in bilateral congenital ectropion uvea was diagnosed at an earlier age (0.02±0.01 years) than unilateral disease (8.9±5.3 years, p=0.002). All eyes required glaucoma surgery with 91% requiring multiple surgeries (3.5±2.1, median 3 surgeries per eye). Trabeculotomy (8 eyes) showed 13% success rate. While none of the 4 eyes which underwent trabeculectomy with mitomycin C needed repeat trabeculectomy, glaucoma drainage device placement, or cycloablation, 75% required bleb revision surgery. Glaucoma drainage devices (7 eyes) had a 57% success rate with 3 eyes requiring subsequent cycloablation (2) or trabeculectomy (1). At final follow-up (8.5±6.6 years, median 7.9 years), all eyes achieved IOP control, and IOP was lower compared to presentation (13.2±2.6 mmHg vs. 32.9±9,9 mmHg, p=0.002). Best-corrected LogMar visual acuity at final follow-up was 0.2±0.2. CONCLUSIONS: Bilateral congenital ectropion uvea presents with glaucoma earlier than unilateral cases. The majority of eyes required multiple glaucoma surgeries. Angle surgery was less effective than trabeculectomy or glaucoma drainage devices. IOP control was obtained in all eyes and affected individuals had good visual outcomes.
Department of Ophthalmology and Visual Sciences, University of Michigan.
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