Skip to main content

Advertisement

SpringerLink
Log in

Efficacy and safety of deep sclerectomy in uveitic glaucoma

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose To evaluate the safety and efficacy of deep sclerectomy with implant and mitomycin C in uveitic glaucoma. Design Prospective, noncomparative case study. Patients and methods Nine patients (13 eyes) with uncontrolled uveitic glaucoma underwent deep sclerectomy with implant from 2002 to 2006. All patients had their uveitis controlled before and after surgery with anti-inflammatory therapy. Main outcome measures Control of intraocular pressure. A secondary outcome measure was the number of antiglaucoma medications required to achieve the desired intraocular pressure. Visual acuity and complication associated with the surgery were monitored. Results Mean follow-up was 21 months (range 12–54 months). Intraocular pressure (IOP) was reduced from a mean preoperative value of 28.7 mmHg to a mean postoperative value of 13.85 mmHg (Wilcoxon signed rank test P = 0.005). At the most recent visit, complete success was obtained in 84.6%, qualified success was obtained in 7.7%, and complete failure in 7.7%. Mean number of antiglaucoma medications was reduced from 3.07 to 0.2 (Wilcoxon signed rank test P = 0.001). Neodymium:YAG goniopuncture was performed in two eyes. Postoperative complications included transient hypotony with maculopathy in one eye, shallow choroidal effusions in two eyes, and progression of cataract in four eyes. Conclusion Deep sclerectomy with implant in uveitic glaucoma appeared to be effective in controlling the IOP at short-term follow-up with no serious postoperative side-effects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kok H, Barton K (2002) Uveitic glaucoma. Ophthalmol Clin North Am 15:375–387

    Article  PubMed  Google Scholar 

  2. Moorthy RS, Mermoud A, Baerveldt G et al (1997) Glaucoma associated with uveitis. Surv Ophthalmol 41:361–394

    Article  PubMed  CAS  Google Scholar 

  3. Merayo-Lloves J, Power WJ, Rodriguez A et al (1999) Secondary glaucoma in patients with uveitis. Ophthalmologica 213:300–304

    Article  PubMed  CAS  Google Scholar 

  4. Panek WC, Holland GN, Lee DA et al (1990) Glaucoma in patients with uveitis. Br J Ophthalmol 74:223–227

    Article  PubMed  CAS  Google Scholar 

  5. Herbert HM, Viswanathan A, Jackson H et al (2004) Risk factors for elevated intraocular pressure in uveitis. J Glaucoma 13:96–99

    Article  PubMed  Google Scholar 

  6. Neri P, Azuara-Blanco A, Forrester JV (2004) Incidence of glaucoma in patients with uveitis. J Glaucoma 13:461–465

    Article  PubMed  Google Scholar 

  7. Sung VC, Barton K (2004) Management of inflammatory glaucomas. Curr Opin Ophthalmol 15:136–140

    Article  PubMed  Google Scholar 

  8. Auer C, Lehoang P, Herbort C et al (2003) Glaucoma associated with uveitis: review on its appraisal, management, and new surgical prospects. Compr Ophthalmol Update 4:203–210

    Google Scholar 

  9. Watson PG, Jakeman C, Ozturk M et al (1990) The complications of trabeculectomy (a 20-year follow-up). Eye 4(Pt 3):425–438

    PubMed  Google Scholar 

  10. Rekonen P, Kannisto T, Puustjarvi T et al (2006) Deep sclerectomy for the treatment of exfoliation and primary open-angle glaucoma. Acta Ophthalmol Scand 84:507–511

    Article  PubMed  Google Scholar 

  11. Drolsum L (2006) Longterm follow-up after deep sclerectomy in patients with pseudoexfoliative glaucoma. Acta Ophthalmol Scand 84:502–506

    Article  PubMed  Google Scholar 

  12. Mielke C, Dawda VK, Anand N (2006) Deep sclerectomy and low dose mitomycin C: a randomised prospective trial in West Africa. Br J Ophthalmol 90:310–313

    Article  PubMed  CAS  Google Scholar 

  13. Detry-Morel M, Detry MB (2006) Five-year experience with non penetrating deep sclerectomy. Bull Soc Belge Ophtalmol 299:83–94

    PubMed  Google Scholar 

  14. Goldsmith JA, Ahmed IK, Crall AS (2005) Nonpenetrating glaucoma surgery. Ophthalmol Clin North Am 18:443–460 vii

    Article  PubMed  Google Scholar 

  15. Guedes RA, Guedes VM (2005) Nonpenetrating deep sclerectomy in Brazil: a 3-year retrospective study. J Fr Ophtalmol 28:191–196

    PubMed  Google Scholar 

  16. Anand N, Atherley C (2005) Deep sclerectomy augmented with mitomycin C. Eye 19:442–450

    Article  PubMed  CAS  Google Scholar 

  17. Shaarawy T, Mansouri K, Schnyder C et al (2004) Long-term results of deep sclerectomy with collagen implant. J Cataract Refract Surg 30:1225–1231

    Article  PubMed  Google Scholar 

  18. Lachkar Y, Neverauskiene J, Jeanteur-Lunel MN et al (2004) Nonpenetrating deep sclerectomy: a 6-year retrospective study. Eur J Ophthalmol 14:26–36

    PubMed  CAS  Google Scholar 

  19. Neudorfer M, Sadetzki S, Anisimova S et al (2004) Nonpenetrating deep sclerectomy with the use of adjunctive mitomycin C. Ophthalmic Surg Lasers Imaging 35:6–12

    PubMed  Google Scholar 

  20. Galassi F, Sodi A, Ucci F et al (2002) Deep sclerectomy in primary open angle glaucoma: comparison among different implants. Acta Ophthalmol Scand Suppl 236:63–64

    Article  PubMed  CAS  Google Scholar 

  21. Towler HM, McCluskey P, Shaer B et al (2000) Long-term follow-up of trabeculectomy with intraoperative 5-fluorouracil for uveitis-related glaucoma. Ophthalmology 107:1822–1828

    Article  PubMed  CAS  Google Scholar 

  22. Stavrou P, Murray PI (1999) Long-term follow-up of trabeculectomy without antimetabolites in patients with uveitis. Am J Ophthalmol 128:434–439

    Article  PubMed  CAS  Google Scholar 

  23. Towler HM, Bates AK, Broadway DC et al (1995) Primary trabeculectomy with 5-fluorouracil for glaucoma secondary to uveitis. Ocul Immunol Inflamm 3:163–170

    Article  Google Scholar 

  24. Patitsas CJ, Rockwood EJ, Meisler DM et al (1992) Glaucoma filtering surgery with postoperative 5-fluorouracil in patients with intraocular inflammatory disease. Ophthalmology 99:594–599

    PubMed  CAS  Google Scholar 

  25. Prata JA Jr, Neves RA, Minckler DS et al (1994) Trabeculectomy with mitomycin C in glaucoma associated with uveitis. Ophthalmic Surg 25:616–620

    PubMed  Google Scholar 

  26. Wright MM, McGehee RF, Pederson JE (1997) Intraoperative mitomycin-C for glaucoma associated with ocular inflammation. Ophthalmic Surg Lasers 28:370–376

    PubMed  CAS  Google Scholar 

  27. Ceballos EM, Beck AD, Lynn MJ (2002) Trabeculectomy with antiproliferative agents in uveitic glaucoma. J Glaucoma 11:189–196

    Article  PubMed  Google Scholar 

  28. Akarsu C, Onol M, Hasanreisoglu B (2003) Postoperative 5-fluorouracil versus intraoperative mitomycin C in high-risk glaucoma filtering surgery: extended follow up. Clin Experiment Ophthalmol 31:199–205

    Article  PubMed  Google Scholar 

  29. Katz GJ, Higginbotham EJ, Lichter PR et al (1995) Mitomycin C versus 5-fluorouracil in high-risk glaucoma filtering surgery. Extended follow-up. Ophthalmology 102:1263–1269

    PubMed  CAS  Google Scholar 

  30. Da Mata AP, Foster CS (1999) Ahmed valve and uveitic glaucoma. Int Ophthalmol Clin 39:155–167

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, College of Medicine, King Saud University, Airport Road, P.O. Box 245, Riyadh, 11411, Saudi Arabia

    Saleh A. Al Obeidan, Essam A. Osman, Abdulrahman M. Al-Muammar & Ahmed M. Abu El-Asrar

Authors
  1. Saleh A. Al Obeidan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Essam A. Osman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Abdulrahman M. Al-Muammar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ahmed M. Abu El-Asrar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ahmed M. Abu El-Asrar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Al Obeidan, S.A., Osman, E.A., Al-Muammar, A.M. et al. Efficacy and safety of deep sclerectomy in uveitic glaucoma. Int Ophthalmol 29, 367–372 (2009). https://doi.org/10.1007/s10792-008-9247-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-008-9247-x

Keywords

Search

Navigation