Surgical outcomes of trabeculectomy and glaucoma drainage implant for uveitic glaucoma and relationship with uveitis activity.
Kwon Hye Jin, Kong Yu Xiang George, Tao Lingwei William, Lim Lyndell L, Martin Keith R, Green Catherine, Ruddle Jonathan, Crowston Jonathan G
AI Summary
This study found similar success rates for trabeculectomy and GDI in uveitic glaucoma. Recurrent uveitis significantly increased trabeculectomy failure, highlighting the need for aggressive inflammation control, especially after trabeculectomy.
Abstract
Importance
This study provides ophthalmologists who manage uveitic glaucoma with important information on factors that can affect the success of surgical management of this challenging disease.
Background
This study examines surgical outcomes of trabeculectomy and glaucoma device implant (GDI) surgery for uveitic glaucoma, in particular the effect of uveitis activity on surgical outcomes.
Design
Retrospective chart review at a tertiary institution.
Samples: Eighty-two cases with uveitic glaucoma (54 trabeculectomies and 28 (GDI) surgeries) performed between 1 December 2006 and 30 November 2014.
Methods
Associations of factors with surgical outcomes were examined using univariate and multivariate analysis.
Main outcome measures
Surgical outcomes as defined in Guidelines from World Glaucoma Association.
Results
Average follow up was 26.4 ± 21.5 months. Overall qualified success rate of the trabeculectomies was not statistically different from GDI, being 67% and 75%, respectively (P = 0.60). Primary and secondary GDI operations showed similar success rates. The most common postoperative complication was hypotony (~30%). Active uveitis at the time of operation was higher in trabeculectomy compared with GDI group (35% vs. 14%). Active uveitis at the time of surgery did not significantly increase risk of failure for trabeculectomies. Recurrence of uveitis was significantly associated with surgical failure in trabeculectomy group (odds ratio 4.8, P = 0.02) but not in GDI group.
Conclusions and relevance: Surgical success rate of GDI was not significantly different from trabeculectomy for uveitic glaucoma in this study. Regular monitoring, early and prolonged intensive treatment of ocular inflammation is important for surgical success particularly following trabeculectomy.
MeSH Terms
Shields Classification
Key Concepts5
The overall qualified success rate of trabeculectomies for uveitic glaucoma was 67%, which was not statistically different from glaucoma drainage implant (GDI) surgery (75%) (P = 0.60) in 82 cases (54 trabeculectomies and 28 GDI surgeries) with uveitic glaucoma.
The most common postoperative complication after glaucoma surgery (trabeculectomy and glaucoma drainage implant) for uveitic glaucoma was hypotony, occurring in approximately 30% of cases in 82 cases with uveitic glaucoma.
Active uveitis at the time of surgery did not significantly increase the risk of failure for trabeculectomies in 54 cases of trabeculectomy for uveitic glaucoma.
Recurrence of uveitis was significantly associated with surgical failure in the trabeculectomy group for uveitic glaucoma (odds ratio 4.8, P = 0.02) but not in the glaucoma drainage implant (GDI) group, in 82 cases (54 trabeculectomies and 28 GDI surgeries) with uveitic glaucoma.
Active uveitis at the time of operation was higher in the trabeculectomy group (35%) compared with the glaucoma drainage implant (GDI) group (14%) in 82 cases (54 trabeculectomies and 28 GDI surgeries) with uveitic glaucoma.
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