Outcome of trabeculectomy with intraoperative mitomycin C for uveitic glaucoma.
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).


CONCLUSIONS
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.
Noble
Jason
J
Faculty of Medicine, University of Toronto, Department of Ophthalmology, Sunnybrook Health Sciences Centre, Ontario, Canada.
Derzko-Dzulynsky
Larissa
L
Rabinovitch
Theodore
T
Birt
Catherine
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000477:Alkylating Agents / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005901:Glaucoma / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D012189:Retrospective Studies; D014130:Trabeculectomy; D016896:Treatment Outcome; D014605:Uveitis / Q000150:complications*
D000477:Alkylating Agents; D000959:Antihypertensive Agents; D016685:Mitomycin