BACKGROUND: The purpose of this study was to compare the outcomes of mitomycin C (MMC)-augmented trabeculectomy in glaucoma patients with uveitis to those without uveitis but with other high-risk characteristics. METHODS: A retrospective comparative cohort analysis consisting of 51 eyes of 51 patients (21 uveitic patients and 30 nonuveitic patients) was performed. Two outcome classifications were analyzed: absolute success (intraocular pressure [IOP]<or=30% baseline without glaucoma medications or 5-fluorouracil (5-FU) injections), and qualified success (IOP<or=30% baseline with glaucoma medications or 5-FU injections). Kaplan-Meier survival curves were constructed for both models. RESULTS: After a mean follow-up of 52 months, uveitis emerged as a negative predictor of success. In the qualified success model, uveitic patients demonstrated survival rates of 90% at 1 year and 79% at 2 years compared with 100% for all time points in the control group (Wilcoxon test, p=0.005). Uveitic patients were more likely to require postoperative 5-FU injections than the control group (33% vs. 10%, p=0.04) and were more likely to require glaucoma medications postoperatively for IOP control (38% vs. 3%, p=0.001). INTERPRETATION: Uveitic glaucoma patients are more likely to require postoperative therapeutic interventions to maintain adequate pressure control in the short-term and are at higher risk of surgical failure in the long-term.
BACKGROUND: The purpose of this study was to compare the outcomes of mitomycin C (MMC)-augmented trabeculectomy in glaucomapatients with uveitis to those without uveitis but with other high-risk characteristics. METHODS: A retrospective comparative cohort analysis consisting of 51 eyes of 51 patients (21 uveitic patients and 30 nonuveitic patients) was performed. Two outcome classifications were analyzed: absolute success (intraocular pressure [IOP]<or=30% baseline without glaucoma medications or 5-fluorouracil (5-FU) injections), and qualified success (IOP<or=30% baseline with glaucoma medications or 5-FU injections). Kaplan-Meier survival curves were constructed for both models. RESULTS: After a mean follow-up of 52 months, uveitis emerged as a negative predictor of success. In the qualified success model, uveitic patients demonstrated survival rates of 90% at 1 year and 79% at 2 years compared with 100% for all time points in the control group (Wilcoxon test, p=0.005). Uveitic patients were more likely to require postoperative 5-FU injections than the control group (33% vs. 10%, p=0.04) and were more likely to require glaucoma medications postoperatively for IOP control (38% vs. 3%, p=0.001). INTERPRETATION:Uveitic glaucomapatients are more likely to require postoperative therapeutic interventions to maintain adequate pressure control in the short-term and are at higher risk of surgical failure in the long-term.
Authors: Ebenezer Daniel; Maxwell Pistilli; Srishti Kothari; Naira Khachatryan; R Oktay Kaçmaz; Sapna S Gangaputra; H Nida Sen; Eric B Suhler; Jennifer E Thorne; C Stephen Foster; Douglas A Jabs; Robert B Nussenblatt; James T Rosenbaum; Grace A Levy-Clarke; Nirali P Bhatt; John H Kempen Journal: Ophthalmology Date: 2017-04-19 Impact factor: 12.079
Authors: Antony William; Martin S Spitzer; Deshka Doycheva; Spyridon Dimopoulos; Martin Alexander Leitritz; Bogomil Voykov Journal: Clin Ophthalmol Date: 2016-05-23