Abstract
Abstract: :
Purpose: To assess the efficacy of viscocanalostomy in eyes affected by uncontrolled glaucoma secondary to uveitis. Methods: All consecutive patients with glaucoma secondary to uveitis and inadequate IOP control (IOP > 21 mmHg) under maximum tolerated medical therapy underwent viscocanalostomy. Patients with active uveitis at time of surgery, peripheral anterior synechiae in the upper quadrant, previous ocular surgery or only seeing eye were excluded. Uveitis etiology was recorded. The ocular variables studied were: IOP, best corrected visual acuity, number of antiglaucoma medications and complications. Success was defined as the achievement of an IOP between 6 and 21 mmHg (inclusive) without medication (complete success), or with one or more antiglaucoma medications and/or goniopuncture (qualified success). Results: Fourheen eyes (14 patients; mean ± SD age 52.2 ± 19.9 years) were operated. Mean follow–up was 55.9 ± 11.6 months (range 23–56). Viscocanalostomy significantly reduced IOP from a mean baseline value of 35.1 ± 7.0 mmHg (range 23–48) to a mean final value of 18.1 ± 4.9 mmHg (range 12–30).(p< 0.0001). Complete success was achieved in 9 out of 14 eyes (64.3%), while qualified success was achieved in 13 out of the 14 eyes (92.8%). Mean preoperative and final number of antiglaucoma medications were 3.4 ± 0.8 (range 2–4) and 0.7± 1.2 (range 0–3) (p=0.0004). Complications were minor and included transient hyphema and postoperative IOP spike. Conclusions: This preliminary study suggests that viscocanalostomy may be considered as a safe and effective surgical alternative for treating glaucoma in patients with uveitis.
Keywords: inflammation • autoimmune disease • clinical (human) or epidemiologic studies: outcomes/complications