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Outcome of trabeculectomy with intraoperative mitomycin C for uveitic glaucoma
Jason Noble1, Larissa Derzko-Dzulynsky, Theodore Rabinovitch
1Faculty of Medicine, University of Toronto, Department of Ophthalmology, Sunnybrook Health Sciences Centre, Ontario, Canada.
Background:
The purpose of this study was to compare the outcomes of mitomycin C (MMC)-augmented trabeculectomy in glaucoma patients with uveitis to those without uveitis but with other high-risk characteristics.
Methods:
A retrospective comparative cohort analysis consisting of 51 eyes of 51 patients (21 uveitic patients and 30 nonuveitic patients) was performed. Two outcome classifications were analyzed: absolute success (intraocular pressure [IOP]
Results:
After a mean follow-up of 52 months, uveitis emerged as a negative predictor of success. In the qualified success model, uveitic patients demonstrated survival rates of 90% at 1 year and 79% at 2 years compared with 100% for all time points in the control group (Wilcoxon test, p=0.005). Uveitic patients were more likely to require postoperative 5-FU injections than the control group (33% vs. 10%, p=0.04) and were more likely to require glaucoma medications postoperatively for IOP control (38% vs. 3%, p=0.001).
Interpretation:
Uveitic glaucoma patients are more likely to require postoperative therapeutic interventions to maintain adequate pressure control in the short-term and are at higher risk of surgical failure in the long-term.
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