title: Surgical outcomes of trabeculectomy and glaucoma drainage implant for uveitic glaucoma and relationship with uveitis activity.
abstract: OBJECTIVE
  This study provides ophthalmologists who manage uveitic glaucoma with important information on factors that can affect the success of surgical management of this challenging disease.
  
  
  BACKGROUND
  This study examines surgical outcomes of trabeculectomy and glaucoma device implant (GDI) surgery for uveitic glaucoma, in particular the effect of uveitis activity on surgical outcomes.
  
  
  METHODS
  Retrospective chart review at a tertiary institution.
  
  
  METHODS
  Eighty-two cases with uveitic glaucoma (54 trabeculectomies and 28 (GDI) surgeries) performed between 1 December 2006 and 30 November 2014.
  
  
  METHODS
  Associations of factors with surgical outcomes were examined using univariate and multivariate analysis.
  
  
  METHODS
  Surgical outcomes as defined in Guidelines from World Glaucoma Association.
  
  
  RESULTS
  Average follow up was 26.4 ± 21.5 months. Overall qualified success rate of the trabeculectomies was not statistically different from GDI, being 67% and 75%, respectively (P = 0.60). Primary and secondary GDI operations showed similar success rates. The most common postoperative complication was hypotony (~30%). Active uveitis at the time of operation was higher in trabeculectomy compared with GDI group (35% vs. 14%). Active uveitis at the time of surgery did not significantly increase risk of failure for trabeculectomies. Recurrence of uveitis was significantly associated with surgical failure in trabeculectomy group (odds ratio 4.8, P = 0.02) but not in GDI group.
  
  
  CONCLUSIONS
  Surgical success rate of GDI was not significantly different from trabeculectomy for uveitic glaucoma in this study. Regular monitoring, early and prolonged intensive treatment of ocular inflammation is important for surgical success particularly following trabeculectomy.
authors.affiliation: Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Kwon
authors.affiliation: Centre for Eye Research Australia Ophthalmology, University of Melbourne, Department of Surgery, East Melbourne, Victoria, Australia.|Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.|Cambridge University Hospital NHS Trust, Cambridge, UK.
authors.forename: Yu Xiang George
authors.initials: YXG
authors.lastname: Kong
authors.affiliation: Centre for Eye Research Australia Ophthalmology, University of Melbourne, Department of Surgery, East Melbourne, Victoria, Australia.
authors.forename: Lingwei William
authors.initials: LW
authors.lastname: Tao
authors.affiliation: Centre for Eye Research Australia Ophthalmology, University of Melbourne, Department of Surgery, East Melbourne, Victoria, Australia.|Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
authors.forename: Lyndell L
authors.initials: LL
authors.lastname: Lim
authors.affiliation: Cambridge University Hospital NHS Trust, Cambridge, UK.
authors.forename: Keith R
authors.initials: KR
authors.lastname: Martin
authors.affiliation: Centre for Eye Research Australia Ophthalmology, University of Melbourne, Department of Surgery, East Melbourne, Victoria, Australia.|Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Green
authors.affiliation: Centre for Eye Research Australia Ophthalmology, University of Melbourne, Department of Surgery, East Melbourne, Victoria, Australia.|Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.|Royal Children's Hospital, Parkville, Victoria, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Ruddle
authors.affiliation: Centre for Eye Research Australia Ophthalmology, University of Melbourne, Department of Surgery, East Melbourne, Victoria, Australia.|Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Crowston
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014605:Uveitis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D014792:Visual Acuity
keywords: glaucoma; glaucoma incisional surgery; trabeculectomy; tube shunt; uveitis