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Long-term efficacy and safety of deep sclerectomy in uveitic glaucoma

Poster Details

First Author: S.Al Obeidan SAUDI ARABIA

Co Author(s):    A. Mousa   E. Osman   A. Al Muammar   A. Abu El Asrar           

Abstract Details

Purpose:

Uveitic glaucoma is one of invasive categories of glaucoma. Interventions to treat such category are varied. However, due to the inflammable nature of the disease, several compilations are usually faced with any intervention. Non-penetrating glaucoma surgery was proven to be less invasive with relatively high success rates. There is a need to assess the long-term efficacy and safety of non-penetrating glaucoma surgery in controlling intraocular pressure (IOP) in uveitic glaucoma in a prospective cohort study design

Setting:

Retrospective cohort study conducted in King Abdul Aziz University Hospital, Riyadh, Saudi Arabia

Methods:

The study is based on 33 consecutive eyes of 21 patients with uveitic glaucoma who underwent non-penetrating deep sclerectomy with Mitomycin C (MMC) and implant. All patients received anti-inflammatory medications to control intraocular inflammation before and after surgery. Goniopuncture was done for cases that developed uncontrolled postoperative IOP. The Main Outcome Measures were: Control of intraocular pressure, visual acuity and frequency of complications associated with surgery.

Results:

The mean follow-up was 33.21(± 19.83) months. The IOP reduced from 37.2 to 14.67 mmHg (p < 0.0001). Complete success was 24/33 (72.7%), qualified success was 7/33 (21.2%). Two (6.1%) eyes failed. The mean number of anti-glaucoma medications reduced from 3.24 to 0.41 (p< 0.0001). Neodymium: YAG goniopuncture was performed in 12 (36.4%) eyes. Postoperative complications included progression of cataract in nine (27.3%) eyes, transient hypotony in 6 (18.2%) eyes, shallow choroidal effusions in four (12.1%) eyes, hypotony with persistent maculopathy in one (3%) eye, hyphema in one (3%) eye and decompression retinopathy in one (3%) eye.

Conclusions:

Deep sclerectomy is safe and effective in patients with uveitic open angle glaucoma. However laser goniopuncture is frequently needed to improve the outcome.

Financial Disclosure:

NONE

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