Efficacy and safety of deep sclerectomy in uveitic glaucoma.
OBJECTIVE
To evaluate the safety and efficacy of deep sclerectomy with implant and mitomycin C in uveitic glaucoma. Design Prospective, noncomparative case study.


METHODS
Nine patients (13 eyes) with uncontrolled uveitic glaucoma underwent deep sclerectomy with implant from 2002 to 2006. All patients had their uveitis controlled before and after surgery with anti-inflammatory therapy. Main outcome measures Control of intraocular pressure. A secondary outcome measure was the number of antiglaucoma medications required to achieve the desired intraocular pressure. Visual acuity and complication associated with the surgery were monitored.


RESULTS
Mean follow-up was 21 months (range 12-54 months). Intraocular pressure (IOP) was reduced from a mean preoperative value of 28.7 mmHg to a mean postoperative value of 13.85 mmHg (Wilcoxon signed rank test P = 0.005). At the most recent visit, complete success was obtained in 84.6%, qualified success was obtained in 7.7%, and complete failure in 7.7%. Mean number of antiglaucoma medications was reduced from 3.07 to 0.2 (Wilcoxon signed rank test P = 0.001). Neodymium:YAG goniopuncture was performed in two eyes. Postoperative complications included transient hypotony with maculopathy in one eye, shallow choroidal effusions in two eyes, and progression of cataract in four eyes.


CONCLUSIONS
Deep sclerectomy with implant in uveitic glaucoma appeared to be effective in controlling the IOP at short-term follow-up with no serious postoperative side-effects.
Department of Ophthalmology, College of Medicine, King Saud University, Riyadh 11411, Saudi Arabia.
Saleh A
SA
Al Obeidan
Essam A
EA
Osman
Abdulrahman M
AM
Al-Muammar
Ahmed M
AM
Abu El-Asrar
D000293:Adolescent; D000328:Adult; D002648:Child; D016503:Drug Delivery Systems / Q000295:instrumentation; D005260:Female; D005901:Glaucoma / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D011182:Postoperative Care; D011183:Postoperative Complications; D011184:Postoperative Period; D011446:Prospective Studies; D012599:Sclerostomy / Q000009:adverse effects* / Q000379:methods*; D015503:Surgical Sponges; D016896:Treatment Outcome; D014605:Uveitis / Q000150:complications*; D055815:Young Adult
D016685:Mitomycin