Skip to main content Skip to main navigation menu Skip to site footer

Successful rate of glaucoma surgery in uveitis glaucoma

  • Elsa Gustianty ,
  • Novaqua Yandi ,
  • R. Maula Rifada ,
  • Andika Prahasta ,


Abstract

Introduction: Glaucoma is one of the most common complications in uveitis. The surgical intervention has been known for a lower success rate in Uveitis Glaucoma (UG). However, it is still a treatment of choice when medical therapy no longer could control the intraocular pressure (IOP). This study aims to describe UG's demographic and clinical characteristics that received glaucoma surgery and the outcome.

Methods: Medical records of UG patients that received glaucoma surgery in 2018-2019 were reviewed. Age, gender, type and etiology of uveitis, duration of uveitis, intraocular pressure (IOP), visual acuity, gonioscopy, ocular characteristic, previous surgery and laser, current surgery, and complication were studied. Success was defined as IOP ≤21 mmHg or reduction >20% from baseline and >6mmHg with or without medication. Failure is defined in the presence of surgery complication that leads to a change of IOP, uncontrolled IOP that needs additional surgery, and visual acuity becomes no light perception (NLP).

Results: 48 patients (57 eyes) with UG underwent glaucoma surgery. The mean age was 47,23±14,62. Anterior uveitis was the most common type of UG, with a mean uveitis duration before surgery was 13,75±17,65 months. The mean initial IOP was 35,81±13,30 mmHg, at the final visit 15,09±3,36. The mean follow-up duration was 6,41±4,02 months. The overall partial success was 75,44% in one month, 67,74% in 6 months

Conclusion: A decrease in IOP was found in all surgery interventions, including Glaucoma Drainage Device (GDD) implant, trabeculectomy with 5-Fluorouracil (5FU), and combined trabeculectomy cataract surgery with or without 5FU, and cyclodestructive laser surgery. There was a high percentage of successful surgery but many losses to follow-up eyes in a short follow-up period.

Keywords: Glaucoma Uveitis Uveitis Glaucoma

References

  1. Straatsma BR. Basic and Clinical Science Course 10: Glaucoma. American Journal of Ophthalmology. 2016;75(1):152–4. Available from: http://dx.doi.org/10.1016/0002-9394(73)90668-5
  2. Shaarawy TM, Sherwood MB, Hitchings RA, Crowston JG. Glaucoma Medical Diagnosis & Therapy [Internet]. Glaucoma. Elsevier; 2015. p. xiv. Available from: http://dx.doi.org/10.1016/b978-0-7020-5193-7.00132-1
  3. Muñoz-Negrete FJ, Moreno-Montañés J, Hernández-Martínez P, Rebolleda G. Current Approach in the Diagnosis and Management of Uveitic Glaucoma. Biomed Res Int. 2015/10/19. 2015;2015:742792. Available from: https://pubmed.ncbi.nlm.nih.gov/26558280
  4. Siddique SS, Suelves AM, Baheti U, Foster CS. Glaucoma and Uveitis. Survey of Ophthalmology. 2013;58(1):1–10. Available from: http://dx.doi.org/10.1016/j.survophthal.2012.04.006
  5. Shaarawy Grehn, Franz., Sherwood, M., World Glaucoma Association., Tarek. WGA guidelines on design and reporting of glaucoma surgical trials [Internet]. The Hague: Kugler Publications; 2009. Available from: http://site.ebrary.com/id/10505611
  6. Pathanapitoon K, Smitharuck S, Kunavisarut P, Rothova A. Prevalence and Visual Outcome of Glaucoma With Uveitis in a Thai Population. Journal of Glaucoma. 2017;26(3):247–52. Available from: http://dx.doi.org/10.1097/ijg.0000000000000592
  7. Cunningham ET, Zierhut M. Uveitic Ocular Hypertension and Glaucoma. Ocular Immunology and Inflammation. 2017;25(6):737–9. Available from: http://dx.doi.org/10.1080/09273948.2017.1415077
  8. Kesav N, Palestine AG, Kahook MY, Pantcheva MB. Current management of uveitis-associated ocular hypertension and glaucoma. Survey of Ophthalmology. 2020;65(4):397–407. Available from: http://dx.doi.org/10.1016/j.survophthal.2019.12.003
  9. Sharon Y, Friling R, Luski M, Campoverde BQ, Amer R, Kramer M. Uveitic Glaucoma: Long-term Clinical Outcome and Risk Factors for Progression. Ocular Immunology and Inflammation. 2016;25(6):740–7. Available from: http://dx.doi.org/10.1080/09273948.2016.1255341
  10. Shimizu A, Maruyama K, Yokoyama Y, Tsuda S, Ryu M, Nakazawa T. Characteristics of uveitic glaucoma and evaluation of its surgical treatment. Clin Ophthalmol. 2014;8:2383–9. Available from: https://pubmed.ncbi.nlm.nih.gov/25473265
  11. Deschenes J, Murray PI, Rao NA, Nussenblatt RB. International Uveitis Study Group (IUSG) Clinical Classification of Uveitis. Ocular Immunology and Inflammation. 2008;16(1–2):1–2. Available from: http://dx.doi.org/10.1080/09273940801899822
  12. Rodriguez-Garcia A, Foster CS. Cataract Surgery in Patients with Uveitis: Preoperative and Surgical Considerations [Internet]. Difficulties in Cataract Surgery. InTech; 2018. Available from: http://dx.doi.org/10.5772/intechopen.71031
  13. Kwon HJ, Kong YXG, Tao LW, Lim LL, Martin KR, Green C, et al. Surgical outcomes of trabeculectomy and glaucoma drainage implant for uveitic glaucoma and relationship with uveitis activity. Clinical & Experimental Ophthalmology. 2017;45(5):472–80. Available from: http://dx.doi.org/10.1111/ceo.12916
  14. Nishizawa A, Inoue T, Ohira S, Takahashi E, Saruwatari J, Iwao K, et al. The Influence of Phacoemulsification on Surgical Outcomes of Trabeculectomy with Mitomycin-C for Uveitic Glaucoma. PLoS One. 2016;11(3):e0151947–e0151947. Available from: https://pubmed.ncbi.nlm.nih.gov/26989899
  15. Wadke V, Lingam V, George R, George AE, Ganesh SK, Biswas J, et al. Phacotrabeculectomy in Eyes With Uveitic Glaucoma. Journal of Glaucoma. 2019;28(7):606–12. Available from: http://dx.doi.org/10.1097/ijg.0000000000001276
  16. Landers J, Martin K, Sarkies N, Bourne R, Watson P. A Twenty-Year Follow-up Study of Trabeculectomy: Risk Factors and Outcomes. Ophthalmology. 2012;119(4):694–702. Available from: http://dx.doi.org/10.1016/j.ophtha.2011.09.043
  17. Almobarak FA, Alharbi AH, Morales J, Aljadaan I. Intermediate and Long-term Outcomes of Mitomycin C–enhanced trabeculectomy as a First Glaucoma Procedure in Uveitic Glaucoma. Journal of Glaucoma. 2017;26(5):478–85. Available from: http://dx.doi.org/10.1097/ijg.0000000000000653
  18. Chow A, Burkemper B, Varma R, Rodger DC, Rao N, Richter GM. Comparison of surgical outcomes of Trabeculectomy, Ahmed shunt, and Baerveldt shunt in uveitic glaucoma. J Ophthalmic Inflamm Infect. 2018;8(1):9. Available from: https://pubmed.ncbi.nlm.nih.gov/29915970
  19. Ramdas WD, Pals J, Rothova A, Wolfs RCW. Efficacy of glaucoma drainage devices in uveitic glaucoma and a meta-analysis of the literature. Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie. 2018/10/11. 2019;257(1):143–51. Available from: https://pubmed.ncbi.nlm.nih.gov/30310971
  20. Holló G. Wound Healing and Glaucoma Surgery: Modulating the Scarring Process with Conventional Antimetabolites and New Molecules [Internet]. Glaucoma Surgery. S. KARGER AG; 2012. p. 79–89. Available from: http://dx.doi.org/10.1159/000334790
  21. Iwao K, Inatani M, Seto T, Takihara Y, Ogata-Iwao M, Okinami S, et al. Long-term Outcomes and Prognostic Factors for Trabeculectomy With Mitomycin C in Eyes With Uveitic Glaucoma. Journal of Glaucoma. 2014;23(2):88–94. Available from: http://dx.doi.org/10.1097/ijg.0b013e3182685167
  22. Gedde SJ, Feuer WJ, Shi W, Lim KS, Barton K, Goyal S, et al. Treatment Outcomes in the Primary Tube Versus Trabeculectomy Study after 1 Year of Follow-up. Ophthalmology. 2018;125(5):650–63.

How to Cite

Elsa Gustianty, Novaqua Yandi, R. Maula Rifada, & Andika Prahasta. (2022). Successful rate of glaucoma surgery in uveitis glaucoma. Bali Medical Journal, 11(2), 614–618. https://doi.org/10.15562/bmj.v11i2.3568
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
2

Total
17

Share

Search Panel

Elsa Gustianty
Google Scholar
Pubmed
BMJ Journal

Novaqua Yandi
Google Scholar
Pubmed
BMJ Journal

R. Maula Rifada
Google Scholar
Pubmed
BMJ Journal

Andika Prahasta
Google Scholar
Pubmed
BMJ Journal