Results of surgical treatment in uveitic glaucoma refractory to medical treatment

Abstract

Purpose : To analyze the results and long-term efficacy of surgical treatment in patients with uveitic glaucoma (UG) refractory to maximum medical treatment.

Methods : Retrospective observational study by reviewing the medical records of patients with a diagnosis of GU refractory to maximum medical treatment who underwent surgery in the Glaucoma Unit at Valladolid Clinical Hospital and Institute of Applied OphthalmoBiology (IOBA) in the last 10 years.

Results : A total of 26 patients and 30 eyes were studied. The average age of the patients was 60.07±14.38 years. Sex distribution was 17 men and 9 women. Complete success (IOP <21 mmHg without additional medical treatment) 1 year (n = 26) after surgery was achieved in 16 (61.5%) cases, and partial success (IOP <21 mmHg with additional medical treatment) was achieved in 10 cases (38.4%), while complete and partial success had a distribution of 50% respectively after 4 years (n = 14) at follow up. The surgical techniques performed were DDG with Ahmed valve implant in 25 (83.3%) cases, EPNP with MMC in three cases (10%), and TB with MMC in two cases (6.7%). The preoperative mean IOP was 31.7±9.2 (range, 16 - 52) mmHg, and the postoperative mean IOP after 1 year was 14.6±4.2 mmHg (53.95% reduction), and the IOP after 4 years was 14.0±3.8 mmHg (55.83% reduction). The mean preoperative antiglaucoma BP used was 3.5±0.8 (2 – 5 range), a mean decrease of 3.2 1 year after surgery and 2.6 4 years after surgery. These values were statistically significant (p <0.001) in all cases.

Conclusions : Surgical treatment can control intraocular pressure in the medium and long term in patients with UG refractory to medical treatment. In up to 50% of the cases a topical hypotensive treatment might be required in addition to surgical treatment to achieve the target IOP.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.