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Is cyclophotocoagulation an option in the management of glaucoma secondary to Fuchs’ uveitis syndrome?

  • Glaucoma
  • Published:
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An Erratum to this article was published on 17 April 2014

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.

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References

  1. Budak K, Akova YA, Yalvac I, Somer D, Aslan BS, Duman S (1999) Cataract surgery in patients with Fuchs’ heterochromic iridocyclitis. Jpn J Ophthalmol 43:308–311

    Article  PubMed  CAS  Google Scholar 

  2. Javadi MA, Jafarinasab MR, Araghi AA, Mohammadpour M, Yazdani S (2005) Outcomes of phacoemulsification and in-the-bag intraocular lens implantation in Fuchs’ heterochromic iridocyclitis. J Cataract Refract Surg 31:997–1001

    Article  PubMed  Google Scholar 

  3. Milazzo S, Turut P, Borhan M, Kheireddine A (1996) Intraocular lens implantation in eyes with Fuchs’ heterochromic iridocyclitis. J Cataract Refract Surg 22(Suppl 1):800–805

    Article  PubMed  Google Scholar 

  4. Ram J, Kaushik S, Brar GS, Gupta A (2002) Phacoemulsification in patients with Fuchs’ heterochromic uveitis. J Cataract Refract Surg 28:1372–1378

    Article  PubMed  Google Scholar 

  5. Tejwani S, Murthy S, Sangwan VS (2006) Cataract extraction outcomes in patients with Fuchs’ heterochromic cyclitis. J Cataract Refract Surg 32:1678–1682

    Article  PubMed  Google Scholar 

  6. Scott RA, Sullivan PM, Aylward GW, Pavesio CE, Charteris DG (2001) The effect of pars plana vitrectomy in the management of Fuchs heterochromic cyclitis. Retina 21:312–316

    Article  PubMed  CAS  Google Scholar 

  7. Waters FM, Goodall K, Jones NP, McLeod D (2000) Vitrectomy for vitreous opacification in Fuchs’ heterochromic uveitis. Eye (Lond) 14:216–218

    Article  Google Scholar 

  8. Jones NP (1991) Glaucoma in Fuchs’ Heterochromic Uveitis: aetiology, management and outcome. Eye (Lond) 5:662–667

    Article  Google Scholar 

  9. La Hey E, de Vries J, Langerhorst CT, Baarsma GS, Kijlstra A (1993) Treatment and prognosis of secondary glaucoma in Fuchs’ heterochromic iridocyclitis. Am J Ophthalmol 116:327–340

    PubMed  Google Scholar 

  10. Liesegang TJ (1982) Clinical features and prognosis in Fuchs’ uveitis syndrome. Arch Ophthalmol 100:1622–1626

    Article  PubMed  CAS  Google Scholar 

  11. Siddique SS, Suelves AM, Baheti U, Foster CS (2013) Glaucoma and uveitis. Surv Ophthalmol 58:1–10

    Article  PubMed  Google Scholar 

  12. Anand N (2011) Deep sclerectomy with mitomycin C for glaucoma secondary to uveitis. Eur J Ophthalmol 21:708–714

    Article  PubMed  Google Scholar 

  13. Ataullah S, Biswas S, Artes PH, O’Donoghue E, Ridgway AE, Spencer AF (2002) Long term results of diode laser cycloablation in complex glaucoma using the Zeiss Visulas II system. Br J Ophthalmol 86:39–42

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  14. Auer C, Mermoud A, Herbort CP (2004) Deep sclerectomy for the management of uncontrolled uveitic glaucoma: preliminary data. Klin Monastbl Augenheilkd 221:339–342

    Article  CAS  Google Scholar 

  15. Bohnsack BL, Freedman SF (2013) Surgical outcomes in childhood uveitic glaucoma. Am J Ophthalmol 155:134–142

    Article  PubMed  Google Scholar 

  16. Da Mata A, Burk SE, Netland PA, Baltatzis S, Christen W, Foster CS (1999) Management of uveitic glaucoma with Ahmed glaucoma valve implantation. Ophthalmology 106:2168–2172

    Article  PubMed  Google Scholar 

  17. Hill RA, Nguyen QH, Baerveldt G, Forster DJ, Minckler DS, Rao N, Lee M, Heuer DK (1993) Trabeculectomy and Molteno implantation for glaucomas associated with uveitis. Ophthalmology 100:903–908

    Article  PubMed  CAS  Google Scholar 

  18. Ho CL, Wong EY, Walton DS (2004) Goniosurgery for glaucoma complicating chronic childhood uveitis. Arch Ophthalmol 122:838–844

    Article  PubMed  Google Scholar 

  19. Juzych MS, Chopra V, Banitt MR, Hughes BA, Kim C, Goulas MT, Shin DH (2004) Comparison of long-term outcomes of selective laser trabeculoplasty versus argon laser trabeculoplasty in open-angle glaucoma. Ophthalmology 111:1853–1859

    Article  PubMed  Google Scholar 

  20. Souissi K, El Afrit MA, Trojet S, Kraiem A (2006) Deep sclerectomy for the management of uveitic glaucoma. J Fr Ophtalmol 29:265–268

    Article  PubMed  CAS  Google Scholar 

  21. Vernon SA, Koppens JM, Menon GJ, Negi AK (2006) Diode laser cycloablation in adult glaucoma: long-term results of a standard protocol and review of current literature. Clin Exp Ophthalmol 34:411–420

    Article  Google Scholar 

  22. Bonfioli AA, Curi AL, Orefice F (2005) Fuchs’ heterochromic cyclitis. Semin Ophthalmol 20:143–146

    Article  PubMed  Google Scholar 

  23. Schlote T, Derse M, Zierhut M (2000) Transscleral diode laser cyclophotocoagulation for the treatment of refractory glaucoma secondary to inflammatory eye diseases. Br J Ophthalmol 84:999–1003

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  24. Bloom PA, Tsai JC, Sharma K, Miller MH, Rice NS, Hitchings RA, Khaw PT (1997) Cyclodiode. Trans-scleral diode laser cyclophotocoagulation in the treatment of advanced refractory glaucoma. Ophthalmology 104:1508–1519, discussion 1519-1520

    Article  PubMed  CAS  Google Scholar 

  25. Kosoko O, Gaasterland DE, Pollack IP, Enger CL (1996) Long-term outcome of initial ciliary ablation with contact diode laser transscleral cyclophotocoagulation for severe glaucoma. The diode laser ciliary ablation study group. Ophthalmology 103:1294–1302

    Article  PubMed  CAS  Google Scholar 

  26. Wong EY, Chew PT, Chee CK, Wong JS (1997) Diode laser contact transscleral cyclophotocoagulation for refractory glaucoma in Asian patients. Am J Ophthalmol 124:797–804

    PubMed  CAS  Google Scholar 

  27. Heinz C, Mingels A, Goebel C, Fuchsluger T, Heiligenhaus A (2008) Chronic uveitis in children with and without juvenile idiopathic arthritis: differences in patient characteristics and clinical course. J Rheumatol 35:1403–1407

    PubMed  Google Scholar 

  28. AGISInvestigators (2002) The advanced glaucoma intervention study (AGIS): 11. Risk factors for failure of trabeculectomy and argon laser trabeculoplasty. Am J Ophthalmol 134:481–498

    Article  Google Scholar 

  29. Mohamed Q, Zamir E (2005) Update on Fuchs’ uveitis syndrome. Curr Opin Ophthalmol 16:356–363

    Article  PubMed  Google Scholar 

  30. Jacobi PC, Dietlein TS, Krieglstein GK (1999) Primary trabeculectomy in young adults: long-term clinical results and factors influencing the outcome. Ophthalmic Surg Lasers 30:637–646

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Centre for Ophthalmology, University Hospital Tübingen, Schleichstr. 12-16, 72076, Tübingen, Germany

    Bogomil Voykov, Christoph Deuter, Manfred Zierhut, Martin Alexander Leitritz & Deshka Doycheva

  2. Department of Dermatology, University Hospital Zürich, Zürich, Switzerland

    Emmanuella Guenova-Hötzenecker

  3. Knappschaft Eye Hospital, Sulzbach, Germany

    Deshka Doycheva

Authors
  1. Bogomil Voykov
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  2. Christoph Deuter
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  3. Manfred Zierhut
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  4. Martin Alexander Leitritz
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  5. Emmanuella Guenova-Hötzenecker
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  6. Deshka Doycheva
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Correspondence to Bogomil Voykov.

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Voykov, B., Deuter, C., Zierhut, M. et al. Is cyclophotocoagulation an option in the management of glaucoma secondary to Fuchs’ uveitis syndrome?. Graefes Arch Clin Exp Ophthalmol 252, 485–489 (2014). https://doi.org/10.1007/s00417-013-2558-2

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  • DOI: https://doi.org/10.1007/s00417-013-2558-2

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