Surgical outcomes of Trab and Tube for Uveitic glaucoma - Experience from a Tertiary Institution Hye Jin Kwon, George YX Kong, William Tao, Lyndell Lim, Keith R Martin, Cathy Green, Jonathan Ruddle, Jonathan Crowston Published Clinical & Experimental Ophthalmology 2017
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Surgical outcomes of Trab and Tube for Uveitic glaucoma - Experience from … · 2017. 6. 15. · 13% 9% Anterior Posterior/pan uveitis Intermediate Indeterminant Uveitis Site 0 5
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Surgical outcomes of Trab and Tube for Uveitic glaucoma -
Experience from a Tertiary Institution
Hye Jin Kwon, George YX Kong, William Tao, Lyndell Lim, Keith R Martin, Cathy
Green, Jonathan Ruddle, Jonathan Crowston
Published Clinical & Experimental Ophthalmology 2017
Backgrounds Uveitic glaucoma can occur in ~20% of patients with uveitis.
Complex surgical problem:• Higher risk of hypotony (ciliary body impairment,
MMC)• Post operative inflammation – risk of scarring
TVT study does not have uveitic glaucoma
Aim: To compare outcomes of Trab vs Tube for uveiticglaucoma & factors affecting outcomes and complications.
Methods
• Retrospective chart review of 82 consecutive cases with uveitic glaucoma surgery (multi-surgeon)
• Between 1 December 2009 and 30 November 2014 at RVEEH • 54 Trab, 28 Glaucoma GDI• Outcome measures based on World Glaucoma Guidelines
• Success- IOP controlled between 6 and 21mmHg or reduction of IOP less than 20% of baseline measured on 2 consecutive visits after 3 months Complete – without medications. Qualified– with adjunct medications. Failure – failed by above criteria, and any return to OT for reoperation, no light perception.
• Uveitic activity assessed based on SUN classification.
– Single pass with 23G needle in creating GDI entry. Test with fluorescene.
Limitation • Retrospective • Trab patients different to GDI patients – more commonly
acute and has active uveitis.• Patient selection to the different intervention is not
randomized.
Reference
1. E. Carreno, S. Villaron, A. Portero et al. Surgical outcomes of uveitic glaucoma. J Opthal InflammInfect. 2011.1:43-53.
2. T Papadaki, I Zacharopoulos, L Pasquale et al. Long-term results of Ahmed Glaucoma Valve Implantation for uveitic glaucoma. Am J Ophthalmol. 144. 1. 62-72.
3. T Kaburaki, T Koshino, H Kawashima et al. Initial trabeculectomy with mitomycin C in eyes with uveitic glaucoma with inactive uveitis. Eye. 2009. 23. 1509-1517.
4. S. Gedde, L. Herndon, J Brandt et al. Postoperative complications in the Tube Versus Trabeculectomy (TVT) study during five years of follow-up. Am J Ophthal. 2012. 153. 804-814
5. E Ceballos, R Parrish, J Schiffman. Outcome of Baerveldt Glaucoma Drainage Implants for the Treatment of Uveitic Glaucoma. Ophthalmology. 2002. 109.2256-2260.
6. S Geede, J Schiffman, W Feuer. Treatment Outcomes in the Tube Versus Trabeculectomy (TVT) study after five years of follow-up. Am J Ophthalmol 2012.152. 789-803.
7. K. Barton, S Gedde, D Budenz et al. The Ahmed Baerveldt Comparison Study: methodology, baseline patient characteristics, and intraoperative complications. Ophthalmol. 2011. 118.435-442
8. D. Heuer, K Barton, F Grehn at al. Consensus on definitions of success. Guidelines on design and reporting of surgical trials. Kugler. 2008. Available at: http://worldglaucoma.org/