Surgical Outcomes of Trabeculectomy in Uveitic Glaucoma: A Long-Term, Single-Center, Retrospective Case-Control Study

Kanaya, Rina; Kijima, Riki; Shinmei, Yasuhiro; Shinkai, Akihiro; Ohguchi, Takeshi; Namba, Kenichi; Chin, Shinki; Ishida, Susumu

doi:10.1155/2021/5550776

Cited by 14 publications

(12 citation statements)

References 30 publications

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“…Previous studies have reported variable risk factors associated with surgical failure in uveitic glaucoma after trabeculectomy, including immediate postoperative IOP spike, early laser suture lysis [ 26 ], male sex [ 19 ], and postoperative exacerbation of inflammation [ 29 ]. Our results indicated that previous history of cataract operation was the only protective factor against surgical failure in patients with uveitic glaucoma.…”

Section: Discussionmentioning

confidence: 99%

“…The reason for such association is not yet proven, and in fact, the results as reported in the relevant prior studies have been contradictory. For example, one study found no association between previous cataract surgery and trabeculectomy [ 29 ], whereas another study reported that previous cataract surgery had a negative effect on both trabeculectomy and Ahmed valve implantation, albeit with only marginal significance [ 17 ]. We performed an additional comparative analysis between pseudophakic ( n = 17) and phakic ( n = 21) eyes, but no difference in their baseline characteristics was found.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Surgical Outcomes between Trabeculectomy with Mitomycin C and Ahmed Valve Implantation with Mitomycin C in Eyes with Uveitic Glaucoma

Lee

Kim

et al. 2022

JCM

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We compared 1-year outcomes of trabeculectomy with mitomycin C (MMC) and Ahmed valve implantation with MMC as a first surgical procedure in patients with uveitic glaucoma. A total 38 eyes of 38 patients undergoing trabeculectomy (n =16) or Ahmed valve implantation (n = 22) were included. Surgical success was defined as intraocular pressure (IOP) ≤21 mmHg, IOP reduction ≥20% from baseline, no secondary glaucoma surgery, and no loss of light perception. The main outcome measurements including success rate, IOP, and the number of antiglaucoma medications and complications were compared. The overall success rates were comparable between the Ahmed and trabeculectomy groups (81.3 vs. 81.8%, p = 0.987). The mean IOPs were similar as well (p = 0.084), though the number of antiglaucoma medications was significantly lower in the trabeculectomy group than in the Ahmed group (1.0 ± 1.2 vs. 2.2 ± 1.1; p = 0.005). A statistically significant reduction in corneal endothelial cell density was noted in the Ahmed group (p = 0.004). Both treatments offered reasonable IOP control and safety for eyes with uveitic glaucoma. However, significantly fewer antiglaucoma medications were used in the trabeculectomy group. Furthermore, our results suggest that cautious postoperative monitoring with regard to corneal endothelial cell density should be additionally performed after Ahmed valve implantation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of Surgical Outcomes between Trabeculectomy with Mitomycin C and Ahmed Valve Implantation with Mitomycin C in Eyes with Uveitic Glaucoma

Lee

Kim

et al. 2022

JCM

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“…Previously, we conducted a similar study on TLE for UG which showed that the surgical outcome for UG was not inferior to that of POAG. 25 We ordinarily choose S-LOT for patients with early to mid-stage glaucoma and TLE for patients with advanced glaucoma, considering a risk of central vision loss because of IOP spikes after S-LOT. Our 2 studies had similar results, although the severity of visual field defects in the patients was different.…”

Section: Discussionmentioning

confidence: 99%

Long-term Outcomes of Modified 360-degree Suture Trabeculotomy for Uveitic Glaucoma Compared with Primary Open Angle Glaucoma

Kijima

Shinmei

Chin

et al. 2022

Journal of Glaucoma

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Précis: A Kaplan-Meier survival curve analysis showed no significant differences in success rates between uveitic glaucoma (UG) and primary open angle glaucoma (POAG) 120 months after modified 360-degree suture trabeculotomy, which was effective for both groups in the long term. Purpose:The aim of this study was to examine the outcomes of modified 360-degree suture trabeculotomy in patients with UG as compared with those with POAG.Patients and Methods: This was a retrospective, nonrandomized, and comparative case series study. Modified 360-degree trabeculotomy using a 5-0 nylon suture (S-LOT) was performed on 51 eyes of 51 patients (54.4 ± 13.4 y) with UG between October 2005 and January 2012 at Hokkaido University Hospital. Age-matched patients with POAG who underwent S-LOT during the same period were enrolled as controls. Written informed consent was obtained from all patients enrolled in the present study. Surgical success was defined as an intraocular pressure (IOP) <18 mm Hg with similar or lower doses of antiglaucoma medications. Kaplan-Meier survival curves of surgical failure were analyzed and compared between UG and POAG. Results:The mean follow-up periods ( ± SD) for UG and POAG were 104.8 ± 44.0 and 98.1 ± 36.3 months (P = 0.23), respectively. Mean preoperative IOP in UG and POAG were 34.9 ± 11.0 and 25.3 ± 9.4 mm Hg (P < 0.001), respectively. After surgery, mean IOP in UG and POAG decreased to 12.0 ± 4.1 and 13.8 ± 3.2 mm Hg, respectively, at 60 months, and 12.1 ± 5.6 and 12.4 ± 1.8 mm Hg (P = 0.86), respectively, at 120 months. The Kaplan-Meier survival curve analysis showed no significant differences in success rates between UG and POAG at the end of the follow-up (Log-rank test, P = 0.13). Success rates in UG and POAG were 70.0 and 62.5% at 60 months, and 67.5 and 41.2% at 120 months, respectively. Conclusion:These results suggest that S-LOT is effective for UG and POAG alike.

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“…At the 6-year mark, 67% of patients had an IOP of less than 18 mmHg and 52% had an IOP of less than 15 mmHg. At the 10-year follow-up, it was noted that 67% of patients still had an IOP of less than 18 mmHg, and 48% of patients had an IOP of less than 15mmHg [21 ▪ ]. Lee et al quoted similar results of 86% of uveitic glaucoma patients achieving IOP less than 21 mmHg, with or without medication posttrabeculectomy with MMC at 6 months and 82% at the 1 year mark [23].…”

Section: Conventional Surgical Optionsmentioning

confidence: 95%

Uveitis and glaucoma: a look at present day surgical options

Seow

Lim

et al. 2023

Current Opinion in Ophthalmology

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Purpose of reviewTo review the various surgical options of management of medically refractory glaucoma in uveitic eyes.Recent findingsUveitic glaucoma is particularly challenging to manage. We look at the evidence for various surgical options, or the lack of, in the surgical management of medically refractory glaucoma in uveitis.SummaryConventional glaucoma filtration surgeries such as trabeculectomy and glaucoma drainage implants were more commonly described first line surgical options in the therapy of medically refractory uveitic glaucoma. However, with the introduction of newer implants and options of minimally invasive glaucoma surgeries, the choice of first line surgeries may now be possibly expanded to include other options. However, more research is required to evaluate the efficacy of the newer surgical options in the management of glaucoma in uveitis patients.

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Surgical Outcomes of Trabeculectomy in Uveitic Glaucoma: A Long-Term, Single-Center, Retrospective Case-Control Study

Cited by 14 publications

References 30 publications

Comparison of Surgical Outcomes between Trabeculectomy with Mitomycin C and Ahmed Valve Implantation with Mitomycin C in Eyes with Uveitic Glaucoma

Comparison of Surgical Outcomes between Trabeculectomy with Mitomycin C and Ahmed Valve Implantation with Mitomycin C in Eyes with Uveitic Glaucoma

Long-term Outcomes of Modified 360-degree Suture Trabeculotomy for Uveitic Glaucoma Compared with Primary Open Angle Glaucoma

Uveitis and glaucoma: a look at present day surgical options

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