Phacotrabeculectomy with mitomycin C in patients with uveitis.

Area of Science:

• Ophthalmology
• Surgical Innovation
• Uveitis Management

Background:

• Uveitic complications, including secondary cataract and glaucoma, pose significant challenges in eye care.
• Effective management strategies are crucial for preserving vision in patients with chronic noninfectious uveitis.

Purpose of the Study:

• To assess the safety and efficacy of combined phacoemulsification, intraocular lens implantation, and trabeculectomy with mitomycin C in managing uveitic complications.
• To compare outcomes between uveitic and nonuveitic eyes undergoing this combined surgical procedure.

Main Methods:

• A retrospective case-control study involving 23 uveitic eyes and 43 nonuveitic control eyes.
• All uveitic eyes received phacotrabeculectomy with mitomycin C.
• Outcomes measured included postoperative vision, intraocular pressure control, complications, and uveitis relapse rates over a minimum one-year follow-up.

Main Results:

• Visual outcomes were similar between uveitic and control groups.
• Intraocular pressure control success rates were favorable in the uveitic group (91.3% at one year, 84.8% at two years) but significantly lower than controls (P = .0423).
• Complications were comparable; surgical failure in uveitic eyes was linked to postoperative uveitis attacks, with no significant change in acute uveitis attack rates post-surgery (P = .283).

Conclusions:

• Phacotrabeculectomy with mitomycin C is a safe and effective option for secondary cataract and glaucoma in uveitic eyes, provided adequate inflammation suppression.
• The reduced surgical success rate in uveitic eyes may be attributed to recurrent postoperative inflammation.