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Surgical outcomes of trabeculectomy and glaucoma drainage implant for uveitic glaucoma and relationship with uveitis activity
Author(s) -
Kwon Hye Jin,
Kong Yu Xiang George,
Tao Lingwei William,
Lim Lyndell L,
Martin Keith R,
Green Catherine,
Ruddle Jonathan,
Crowston Jonathan G
Publication year - 2017
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.12916
Subject(s) - trabeculectomy , medicine , glaucoma , uveitis , glaucoma surgery , intraocular pressure , ophthalmology , univariate analysis , surgery , multivariate analysis
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.