Surgical outcomes of trabeculectomy and glaucoma drainage implant for uveitic glaucoma and relationship with uveitis activity

Kwon, Hye Jin; Kong, Yu; Tao, Lingwei William; Lim, Lyndell L; Martin, Keith R; Green, Catherine; Ruddle, Jonathan B; Crowston, Jonathan G

doi:10.1111/ceo.12916

Cited by 53 publications

(26 citation statements)

References 27 publications

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“…But the cumulative probability of failure after 5 years of follow-up was significantly greater in trabeculectomy eyes (62%) compared with glaucoma drainage device eyes (25%), and they concluded that non-valved shunt surgery is more likely to maintain IOP control in long-term 32 . Kwon and colleagues 33 in a recent retrospective study on patients with uveitis reported that the rate of success in the trabeculectomy and glaucoma device implant was not significantly different.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of glaucoma in Fuchs uveitis syndrome: Trabeculectomy or Ahmed glaucoma valve

Nilforushan

Yadgari

Alemzadeh

2019

Journal of Current Ophthalmology

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Purpose To evaluate the outcome of trabeculectomy versus Ahmed glaucoma valve (AGV) surgery in patients with Fuchs uveitis Syndrome (FUS). Methods Twenty-eight eyes with uncontrolled glaucoma and at least 6 months of follow-up were enrolled. In 16 eyes trabeculectomy and in 12 eyes AGV implant were performed. The primary outcome measure was surgical success defined as 5 < intraocular pressure (IOP) ≤ 21 mmHg (criterion A) and 5 < IOP ≤ 16 mmHg (criterion B), with at least 20% reduction in IOP, either with no medication (complete success) or with no more than preoperative medications (qualified success). The sum of complete and qualified success was defined as cumulative success. Results The mean age of the patients in the trabeculectomy group and the AGV group was 44.92 ± 9.02 and 45.76 ± 7.10 years, respectively ( P = 0.79). The mean duration of follow-up was 23.06 ± 12.03 months in the trabeculectomy group and 22.83 ± 13.63 months in the AGV group ( P = 0.96). The baseline mean IOP in trabeculectomy was 26.81 ± 6.69 mmHg which decreased to 11.61 ± 4.15 mmHg at last visit ( P < 0.001). In the AGV group, mean IOP was 31.41 ± 6.76 at baseline that changed to 22.41 ± 5.09 at last visit ( P = 0.005). According to criterion A, cumulative success rates were 100% and 91% at 6 months and 76% and 9% at 36 months in the trabeculectomy and the AGV group, respectively. Cumulative success rates at 6 months were 93% and 58% and 65% and 7% at 36 months according to criterion B in the trabeculectomy and the AGV group, respectively. Kaplan-Meier survival analysis revealed a significant association between surgical method and cumulative success rate over 36 months (based on criteria A: P = 0.02, and based on criteria B: P = 0.007). Conclusion The success rate of trabeculectomy was higher than AGV in the surgical management of glaucoma in FUS during a medium-term follow-up.

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Section: Discussionmentioning

confidence: 99%

Surgical management of glaucoma in Fuchs uveitis syndrome: Trabeculectomy or Ahmed glaucoma valve

Nilforushan

Yadgari

Alemzadeh

2019

Journal of Current Ophthalmology

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“…used valved Ahmed implants in 14 patients with uveitic glaucoma secondary to Behcet disease and reported the cumulative probability of surgical success rate of 90.9% at 18 months follow-up 33 . Kwon et al examined the outcome of AGV implantation in 28 patients with uveitic glaucoma including FHIC and reported a success rate of 75% during the 2-year follow-up 36 . Voykov and colleagues assessed the short and intermediate-term success rate of AGV implantation in 17 patients with FHIC- associated glaucoma 37 .…”

Section: Discussionmentioning

confidence: 99%

Fuchs heterochromic iridocyclitis-associated glaucoma: a retrospective comparison of primary Ahmed glaucoma valve implantation and trabeculectomy with mitomycin C

et al. 2018

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Background: The aim of this study was to compare the safety and efficacy of primary trabeculectomy with mitomycin C and Ahmed glaucoma valve (AGV) implantation in patients with Fuchs heterochromic iridocyclitis (FHIC)-related glaucoma, a rare complication of an uncommon form of uveitis. Methods : In this retrospective comparative case series, 26 FHIC-associated glaucoma patients received trabeculectomy (n=12) or an AGV (n=14). Primary outcome measures were surgical success, defined as intraocular pressure (IOP) ≤21 mmHg, decreasing ≥20% from baseline, and no secondary glaucoma surgery. Secondary outcome measures were the number of glaucoma medications, complications, best corrected visual acuity (BCVA), and IOP. Results: The follow-up was 34.0±17.7 months in patients that received trabeculectomy and 33.4±18.6 months in AGV (P= 0.837). The cumulative probability of success rate was 41.7% for trabeculectomy and 85.7% for AGV, with no significant difference in complications (P>0.05). The IOP in patients that received trabeculectomy dropped from 23.4±3.3 mmHg to 21.6±5.2 mmHg at the final visit (P= 0.041). In patients that received AGV, the IOP decreased from 24±7.8 to 17.1±2.6 mmHg (P= 0.003). The number of glaucoma medications at baseline were 3.3±0.5 in those that received trabeculectomy and 3±0.6 in those that received AGV (P=0.233), and decreased to 2.4±1.0 (P=0.008) and 1.7±0.6 (P=0.002), respectively. BCVA was equal in both groups and did not change (P>0.05). Conclusion: Primary AGV had a higher success rate than trabeculectomy, with patients also needing fewer medications for the management of FHIC-associated glaucoma.

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“…Unterschiedliche Studien vergleichen die Erfolgsraten zur TE. So fanden sich für eine primäre oder sekundäre GDI-Implantation vergleichbare Erfolgsraten (IOD ≤ 21 mmHg) von 75 % im Vergleich zu 67 % bei TE [69]. Zwei aktuelle Studien vergleichen eine TE mit einer GDI-Implantation.…”

Section: Glaukomdrainage-implantateunclassified

Sekundärglaukom bei Uveitis

Lommatzsch

Heinz

2018

Klin Monatsbl Augenheilkd

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An intraocular pressure increase with development of glaucomatous damage is a common complication of uveitis. The prevalence has a wide range depending on various factors such as the underlying uveitis type and the duration of the disease. Pathogenetically, a distinction must be made between a secondary angle closure component and the more frequently occurring open-angle glaucoma. In diagnostics, in addition to the clinical optic nerve head assessment, perimetry and tonometry, the use of imaging examination equipment, such as OCT and HRT, are recommended. In the context of uveitic glaucoma, it must be considered in the evaluation, because the glaucoma-typical changes are generally less pronounced or can be concealed by retinal swelling in comparison with other forms of glaucoma. Therapeutically, drug therapy in the form of eye drops continues to be a first-line recommendation, with the use of topical carbonic anhydrase inhibitors or beta-blockers primarily preferred, depending on the contraindications. An operative therapy follows after unsuccessful or inadequate conservative therapy: the adequate surgical technique depends on the respective finding and includes actually techniques such as filtering procedures and glaucoma drainage devices.

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Surgical outcomes of trabeculectomy and glaucoma drainage implant for uveitic glaucoma and relationship with uveitis activity

Cited by 53 publications

References 27 publications

Surgical management of glaucoma in Fuchs uveitis syndrome: Trabeculectomy or Ahmed glaucoma valve

Surgical management of glaucoma in Fuchs uveitis syndrome: Trabeculectomy or Ahmed glaucoma valve

Fuchs heterochromic iridocyclitis-associated glaucoma: a retrospective comparison of primary Ahmed glaucoma valve implantation and trabeculectomy with mitomycin C

Sekundärglaukom bei Uveitis

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