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L Arellanes-Garcia, SC Quintero-y De León, P Navarro-López, D Alvares-Celorio, F Gil-Carrasco, E Salinas-Van Orman; Surgical Treatment in Uveitic Glaucoma . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3375.
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Purpose:To assess the outcome of different surgical techniques in the treatment of uncontrolled uveitic glaucoma patients. Methods:The clinical files of all patients with uncontrolled uveitic glaucoma requiring surgical treatment, seen from September 1988 to April 2001 were retrospectively reviewed. Overall success was defined as Intraocular Pressure (IOP) between 6-21mmHg with or without anti-glaucomatous therapy. Results:We included 108 eyes of 108 patients, 67% were females, mean age was 46 years (range 4 -83 years). Mean postoperative follow up was 32 months (range 16-48 months). Uveitic etiologies were: Idiopathic Anterior Uveitis 26.85%, Fuch’s heterochromic iridocyclitis 18.51%, Vogt Koyanagi Harada disease 17.5%, Herpetic Keratouveitis 13.8%, Pars Planitis 11.1%, others 12.06%. Trabeculectomy (T) was performed in 16% of the patients, Trabeculectomy+Mitomycin C (T+MMC) in 40%, Ahmed Valve Implant (AVI) in 35% and sclerectomy (S) in 9%. Preoperatively 91% of cases had none to mild ocular inflammation. Trabeculectomy had an overall success rate of 83%, T + MMC 97%, AVI 87%, and S 80%. Complications occurred in 54% of the patients who underwent T, 40% in T-MMC, 30% in AVI, and 33% in S. The most common complications were choroidal detachment (16%), seidel (12%), cystic bleb (12%)in T-MMC, and choroidal detachment (8%), cystic bleb (11%), and corneal edema (11%) in AVI. Conclusion:: T-MMC and AVI were the most effective techniques in lowering the IOP.
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