J Korean Ophthalmol Soc.  2015 Sep;56(9):1408-1415. 10.3341/jkos.2015.56.9.1408.

Comparative Results of Trabeculectomy with Mitomycin C in Uveitic Glaucoma versus Primary Open-Angle Glaucoma

• Lee YH
• Oh HJ
• Cha SC

• KMID: 2214557
• DOI: http://doi.org/10.3341/jkos.2015.56.9.1408

Abstract

PURPOSE
In this study we evaluated the long-term outcomes and prognostic factors of trabeculectomy with mitomycin C (MMC) in eyes with uveitic glaucoma (UG) compared with primary open-angle glaucoma (POAG).
METHODS
We performed a retrospective chart review of 60 eyes with UG and 402 eyes with POAG that were followed up for at least 1 year after trabeculectomy with MMC between June 2000 and December 2012. The review included intraocular pressure (IOP), number of anti-glaucoma medications, and postoperative complications. Surgical success was analyzed using the Kaplan-Meier life-table method based on 2 definitions of successful IOP control with topical anti-glaucoma medications: Definition A (IOP < or = 15 mm Hg) and Definition B (IOP < or = 18 mm Hg). Risk factors for surgical failure of trabeculectomy were analyzed using the Cox proportional hazards model.
RESULTS
Success rate at 5 years after trabeculectomy was lower in UG than in POAG (65.8% vs. 76.4%, Definition B), but without significant difference. However, UG had a significantly lower cumulative probability of success than POAG based on Kaplan-Meier survival curves (p = 0.049 and 0.044, respectively). Postoperative hypotony and hypotony maculopathy was more frequent in UG (p = 0.044 and 0.044, respectively). In UG, the Cox proportional hazards model showed postoperative shallow anterior chamber was associated with surgical failure in both Definition A and B.
CONCLUSIONS
Long-term results of trabeculectomy with MMC in eyes with UG showed successful IOP control similar to POAG. Trabeculectomy with MMC is a reasonable surgical option for the management of UG.

Keyword

Primary open angle glaucoma; Trabeculectomy; Uveitic glaucoma

MeSH Terms

Anterior Chamber
Glaucoma*
Glaucoma, Open-Angle*
Intraocular Pressure
Kaplan-Meier Estimate
Mitomycin*
Postoperative Complications
Proportional Hazards Models
Retrospective Studies
Risk Factors
Trabeculectomy*
Mitomycin

Figure

• 

  Figure 1. Kaplan-Meier curves for successful intraocular pres-sure (IOP) control by trabeculectomy with mitomycin C in pa-tients with uveitic glaucoma (UG, solid line) and primary open angle glaucoma (POAG, broken line). Definition of success of IOP control was IOP ≤ 15 mm Hg with medication (Definition A). Cumulative probability of success at 5 years was 52.4 ±0.1% in UG and 56.7 ± 0.1% in POAG ( p = 0.049, log-rank test).

• 

  Figure 2. Kaplan-Meier curves for successful intraocular pres-sure (IOP) control by trabeculectomy with mitomycin C in pa-tients with uveitic glaucoma (UG, solid line) and primary open angle glaucoma (POAG, broken line). Definition of success of IOP control was IOP ≤ 18 mm Hg with medication (Definition B). Cumulative probability of success at 5 years was 65.8 ±0.8% in UG and 76.4 ± 0.3% in POAG ( p = 0.044, log-rank test).

Reference

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