Posters

Evaluating the efficacy and effectiveness of Viscocanolostomy/Phacoviscocanolostomy for the management of uveitic glaucoma: 5 year follow-up outcomes

Poster Details

First Author: A.El Salloukh UK

Co Author(s):    A. El Salloukh   A. Ansari   A. Chiu   D. Mathews           

Abstract Details

Purpose:

Uveitic glaucoma commonly leads to more intense optic nerve damage than other types of glaucoma, causing glaucomatous optic nerves and visual field defects. Anterior uveitis is the most commonly associated risk factor. Surgical intervention is usually indicated when all medical treatment has failed. Studies indicate that about 30% of uveitic glaucoma patients lead to surgical intervention. We report five-year results for 16 eyes of uveitic glaucoma managed with viscocanalostomy (VC)/Phaco viscocanalostomy (PV).

Setting:

Sixteen patients treated at the Stanley Eye Unit, Abergele, North Wales were included. All patients were on maximum medical therapy and required surgical intervention for uncontrolled raised intraocular pressures. Surgery was completed by a single consultant ophthalmic surgeon well versed in non-penetrating glaucoma surgery.

Methods:

Retrospective analysis on all uveitic glaucoma cases meeting a five-year follow was completed. All patients were managed surgically with either viscocanolostomy (VC) or phacoviscocanolostomy (PVC). Outcomes evaluated included intraocular pressures measurement pre-listing, on day 1, year 1 to year 5. Surgery was considered successful if the postoperative I OP was reduced to below 21 mmHg or reduced by more than 30 % compared to the pre-listing IOP with or without glaucoma drops.

Results:

A total of 16 patients with uveitic glaucoma were reviewed. Complete success rate was defined as achieving an IOP lower than 21 mmHg without medications, and qualified success was achieved when IOP was lower than 21 mmHg with topical medical therapy. 75% of the total population studied had a successful outcome. In the group of patients requiring further surgery, 50% of patients had previous surgeries. There was a mean number of 4 interventions before their first surgery. Success rated were prognostically linked to lower mean number of interventions and lower percentage of previous surgeries.

Conclusions:

There remains a significant paucity of information in the utilization of PVC in uveitic glaucoma. The advantage of nonpenetrating procedures, such as deep sclerectomy (DS) and viscocanalostomy (VC) includes the lack of entry into the anterior chamber and the avoidance of an iridectomy which may reduce intraocular inflammation and postoperative complications. Thus creating a less hostile environment whilst tacking intraocular pressure in this inflammatory disorder. Our study shows that non-penetrating surgeries are successful in treating advanced uveitic glaucoma.

Financial Disclosure:

None