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Ardalan Aminlari, Ingrid U Scott, George C Papachristou, Christine Callahan, Ahmad Aref; Practice Preferences in the Management of Uveitic Glaucoma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):541.
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This study was undertaken to ascertain practice preferences of members of the American Glaucoma Society (AGS) regarding the treatment of uveitic glaucoma. With such information, rational approaches to the management of uveitic glaucoma can be planned.
An anonymous survey using multiple-choice questions was constructed on www.surveymonkey.com. An email containing an explanation of the study and the survey link was sent to members of the American Glaucoma Society (AGS). Basic demographic information and practice characteristics were collected. Respondents were asked questions pertaining to their management of uveitic glaucoma, such as their preferred initial treatment of choice, surgical techniques, use of prostaglandin analogs, and changes to management if the patient were a child.
The survey was completed by 155 of 960 AGS members for a response rate of 16.1%. 73% of respondents use a beta-blocker as first line intraocular pressure lowering therapy. A majority use prostaglandin analogs in patients with active inflammation (78%) and in patients without active inflammation (95%). 60% of respondents reported that their first line surgical choice in active inflammation is a valved implant, and 33% would use a smaller implant than they would typically use. First line surgery in patients without active inflammation is trabeculectomy with an antifibrotic (37%), valved implant (25%), or non-valved implant (20%). Preoperative (38.4%) and postoperative oral steroids (41.7%) are the most commonly used adjuncts to surgery. Most respondents (62%) reported they would not change their management if the patient is a child.
The majority of respondents use a topical beta-blocker as first line IOP-lowering therapy for patients with uveitic glaucoma. When additional treatment is required, and despite prostaglandin-induced inflammation reported in the literature, the majority of respondents use prostaglandin analogs, both in patients with active inflammation and without active inflammation. If surgical intervention is necessary, first line surgical procedure selected differs based on presence or absence of active inflammation, with a valved implant the most frequently selected procedure for patients with active inflammation and trabeculectomy with an antifibrotic being the most commonly selected procedure for patients without active inflammation. Most respondents would not alter their management if the patient is a child.
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