Phacotrabeculectomy with mitomycin C in patients with uveitis.
OBJECTIVE
To evaluate the safety and efficacy of combined phacoemulsification, intraocular lens implantation, and trabeculectomy with mitomycin C for the management of uveitic complications.


METHODS
Retrospective case-control study.


METHODS
We conducted a retrospective review of the records of 23 consecutive eyes with chronic noninfectious uveitis (uveitic group) and 43 nonuveitic eyes (control group) that had received primary phacotrabeculectomy. Mitomycin C was used in all the uveitic eyes. Considering the high preoperative intraocular pressure (IOP) of the uveitic group, nonuveitic eyes that had a preoperative IOP of >or=20 mm Hg or that had been given two or more medications were included in the control group. All patients were followed for at least one year. The main outcome measures were postoperative vision, IOP control, complications, and acute uveitis relapse rates.


RESULTS
Visual outcome of the uveitic group was similar to the control group. In the uveitic group, the success rate of IOP control (91.3% at one year, 84.8% at two years) was favorable but was significantly lower than in the control group (P = .0423). Complications were comparable between the groups. Primary surgical failure in the uveitic group was associated with the postoperative acute uveitis attack. In the uveitic group, the acute uveitis attack rate showed no change after surgery (P = .283).


CONCLUSIONS
With adequate inflammation suppression, phacotrabeculectomy with mitomycin C is an effective and safe therapeutic option for the management of secondary cataract and glaucoma in uveitic eyes. A lower surgical success rate of the uveitic group might be attributable to the postoperative inflammation recurrence.
Park
Un-Chul
UC
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
Ahn
Jae Kyoun
JK
Park
Ki Ho
KH
Yu
Hyeong Gon
HG
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000477:Alkylating Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016022:Case-Control Studies; D002386:Cataract / Q000209:etiology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005901:Glaucoma / Q000209:etiology / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage* / Q000009:adverse effects; D018918:Phacoemulsification / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014605:Uveitis / Q000150:complications*
D000477:Alkylating Agents; D016685:Mitomycin