Initial trabeculectomy with mitomycin C in eyes with uveitic glaucoma with inactive uveitis.
OBJECTIVE
To analyse clinical outcomes of trabeculectomy with mitomycin C (MMC) in eyes with uveitic glaucoma (UG) with inactive uveitis and compare them to those in eyes with primary open-angle glaucoma (POAG).


METHODS
Retrospective non-randomized comparative interventional case series.


METHODS
A total of 53 eyes with UG and 80 eyes with POAG that received MMC trabeculectomy as an initial ocular surgery with average follow-up of 5.4 years were reviewed retrospectively. The intraocular pressure (IOP) control and persistence of filtering bleb were analysed using the Kaplan-Meier life-table method based on two definitions of successful IOP control, ie complete success (IOP<or=15 mm Hg without anti-glaucoma medications) and qualified success (IOP<or=15 mm Hg with topical anti-glaucoma medications). The incidences of postoperative complications were also examined.


RESULTS
Complete success rate for postoperative IOP control at 5 years after trabeculectomy was 57.1+/-7.5% (mean+/-SE) in UG, being comparable to that in POAG (53.7+/-6.1%), and those of qualified success was 64.7+/-7.0 and 65.9+/-5.5% (P=0.60 and 0.53) respectively. Persistence of filtrating blebs was shorter in UG than in POAG (P=0.031). Postoperative inflammation in UG was associated with worse postoperative IOP control and loss of filtering bleb (P=0.027 and 0.021). Postoperative long-standing ocular hypotony was more frequent in UG (P=0.0063).


CONCLUSIONS
An MMC trabeculectomy for UG with inactive uveitis as an initial ocular surgery had IOP control comparable to that for POAG, suggesting that pre-existing uveitis itself is not a risk factor for failure of a filtering surgery.
Kaburaki
T
T
Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan. kabutosi-tky@umin.ac.jp
Koshino
T
T
Kawashima
H
H
Numaga
J
J
Tomidokoro
A
A
Shirato
S
S
Araie
M
M
D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D001768:Blister / Q000188:drug therapy; D003131:Combined Modality Therapy; D004502:Education, Medical, Continuing; D005260:Female; D005901:Glaucoma / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000379:methods*; D014605:Uveitis / Q000150:complications*
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin