The Effect of Perioperative Uveitis Control on the Success of Glaucoma Surgery in Uveitic Glaucoma
Received 14 January 2021
Accepted for publication 24 February 2021
Published 9 April 2021 Volume 2021:15 Pages 1465—1475
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Scott Fraser
Moustafa S Magliyah,1 Abdulrahman H Badawi,2 Abdulaziz A Alshamrani,2 Rizwan Malik,3 Hassan Al-Dhibi2
1Ophthalmology Department, Prince Mohammed Medical City, AlJouf, Saudi Arabia; 2Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; 3Glaucoma Division, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
Correspondence: Moustafa S Magliyah
Vitreoretinal Division, King Khaled Eye Specialist Hospital, Al- Oruba Street, PO Box 7191, Riyadh, 11462, Kingdom of Saudi Arabia
Tel +966 11 482 1234 ext. 2655
Fax +966 11 4821234 ext. 3773
Email [email protected]
Purpose: To study the effects of perioperative uveitis control (PUC) on postoperative intraocular pressure (IOP) and uveitis activity in uveitic glaucoma (UG) patients who required glaucoma surgeries.
Patients and Methods: A retrospective chart review of 109 patients (120 eyes) which had glaucoma surgery for UG. A total of 66 eyes which had PUC were compared to 54 eyes which did not have. Measurements of IOP and uveitis activity were recorded preoperatively and over 2 years postoperatively. Average number of antiglaucoma medications and frequency of surgical failure were obtained in both groups.
Results: Over 2 years postoperatively, average IOP was lower in eyes which had PUC. Significant differences in IOP were found at 3 months (P = 0.004), 6 months (P = 0.001), 1 year (P < 0.001), and 2 years (P < 0.001). Lower grades of anterior chamber (AC) inflammation were found in eyes which had PUC. Significant differences were found at 1 month (P < 0.001), 3 months (P < 0.001) and 6 months (P = 0.001). Mean number of antiglaucoma medications at last visit was 0.7 ± 1.1 for eyes which had PUC and 2.6 ± 1.5 for eyes which did not have PUC (P < 0.001). Among eyes which had PUC, only two eyes required second glaucoma surgeries, while 16 eyes with no PUC required further glaucoma surgeries after 27.7 ± 12.5 months (P < 0.001).
Conclusion: Proper PUC in patients going for UG surgeries results in lower IOP levels and less AC inflammation over 2 years postoperatively. A comprehensive PUC regimen is needed for uveitic glaucoma patients going for surgeries.
Keywords: perioperative uveitis control, uveitic glaucoma, glaucoma surgeries, immunosuppressive therapy
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