title: Is cyclophotocoagulation an option in the management of glaucoma secondary to Fuchs' uveitis syndrome?
abstract: BACKGROUND
  Glaucoma is one of the sight-threatening complications of Fuchs' uveitis syndrome (FUS) and the most difficult to manage. The goal of this study was to assess the efficacy and safety of cyclophotocoagulation (CPC) in the management of glaucoma secondary to FUS.
  
  
  METHODS
  In a retrospective analysis, the charts of all patients with FUS referred to our clinic from January 2002 to December 2012 were reviewed. In patients with glaucoma or ocular hypertension, controlled eye pressure was defined using two alternative upper limits of 6 ≤ IOP ≤ 21 mmHg and 6 ≤ IOP ≤ 18 mmHg at 1 year follow-up.
  
  
  RESULTS
  One hundred and seventy-six patients with FUS were included in this study. Of those, 28 had ocular hypertension (OHT) or glaucoma. Mean maximal intraocular pressure (IOP) of patients with glaucoma/OHT was 40.8 mmHg. Twenty-three patients (82.1 %) had maximal IOP levels of 35 mmHg or higher. Sixteen patients with glaucoma/OHT underwent CPC alone (ten patients) or in combination with other surgical procedures (six patients). After 1 year, control of IOP for both upper limits (6 ≤ IOP ≤ 18 mmHg) and (6 ≤ IOP ≤ 21 mmHg) was achieved in six of ten patients (60 %) who received CPC alone, and in five of six patients (83.3 %) who required additional surgery after CPC. The mean number of cycloablative procedures was 1.3 (range 1-2) in the CPC alone group and 1.2 (range 1-2) in patients for whom CPC was used as adjunct therapy. There was no exacerbation of intraocular inflammation, no postoperative hypotony and no phthisis bulbi in the 16 patients who underwent CPC.
  
  
  CONCLUSIONS
  CPC is a safe and effective procedure that should be considered if medical treatment has failed to control glaucoma in FUS.
authors.affiliation: Centre for Ophthalmology, University Hospital Tübingen, Schleichstr. 12-16, 72076, Tübingen, Germany, bogomil.voykov@med.uni-tuebingen.de.
authors.forename: Bogomil
authors.initials: B
authors.lastname: Voykov
authors.forename: Christoph
authors.initials: C
authors.lastname: Deuter
authors.forename: Manfred
authors.initials: M
authors.lastname: Zierhut
authors.forename: Martin Alexander
authors.initials: MA
authors.lastname: Leitritz
authors.forename: Emmanuella
authors.initials: E
authors.lastname: Guenova
authors.forename: Emmanuella
authors.initials: E
authors.lastname: Guenova-Hötzenecker
authors.forename: Deshka
authors.initials: D
authors.lastname: Doycheva
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002924:Ciliary Body / Q000601:surgery*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000150:complications*; D005901:Glaucoma / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D017075:Laser Coagulation; D054023:Lasers, Semiconductor / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome; D014606:Uveitis, Anterior / Q000150:complications*; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents