AI Article Synopsis
- The study aimed to compare the effectiveness of surgical treatments for uveitic glaucoma (UG) and steroid-induced glaucoma (SIG) in children, focusing on intraocular pressure control, visual acuity, and surgery failure rates.
- 12 cases of UG and 40 cases of SIG underwent primary trabeculectomy, and results showed no significant differences in IOP control, visual acuity, and medication needs between the two groups; however, UG patients had worse visual outcomes at the last visit.
- The research found that younger age and male gender were associated with higher failure rates, while preoperative uveitic attacks seemed to offer some protective benefits, although the overall outcomes were similar for both UG and SIG after normal trabeculect
Article Abstract
Purpose: To compare outcomes of surgical management of uveitic glaucoma (UG) and steroid-induced glaucoma (SIG) in children in terms of intraocular pressure (IOP) control, visual acuity, and associations for failure.
Methods: This was a retrospective case-control study of consecutive UG (cases) and non-uveitic SIG (controls) in children <18 years of age who underwent surgery between January 2005 and December 2017.
Results: Primary trabeculectomy with mitomycin C (MMC) was performed in 12 cases (mean age: 9.2 ± 4.3 years) and 40 controls (mean age: 10.4 ± 3.7 years) (P = 0.33). Primary phaco-trabeculectomy with MMC was performed in 11 cases (mean age: 11.4 ± 4.7 years) and 16 controls (mean age: 10.4 ± 3.4 years) (P = 0.57). IOP control (P = 0.26), visual acuity (P = 0.97), number of glaucoma medications (P = 0.06), and survival rates (49% cases vs. 68% controls at 5 years; P = 0.22) were similar between the two groups following trabeculectomy. Survival rates in the phaco-trabeculectomy group at 5 years were 68% cases vs. 69% controls (P = 0.71). IOP was higher (P = 0.008) and visual acuity was worse (P = 0.02) in cases at the last visit. Associations for failure (univariate analysis) were younger age (OR: 6.29, 95% CL: 1.43, 27.67; P = 0.03) and male gender (OR: 4.79, 95% CL: 1.09, 20.97; P = 0.04). On multivariate analysis, younger age (OR: 11.985, 95% CL: 1.071, 134.153; P = 0.04) remained significant. Preoperative number of uveitic attacks was protective on univariate (OR: 0.75, 95% CL: 0.48, 1.15; P = 0.1) and multivariate analyses (OR: 0.49, 95% CL: 0.24, 0.09; P = 0.04).
Conclusion: Outcomes of trabeculectomy between cases and controls were similar in our series. However, phaco-trabeculectomy in pediatric uveitic eye group fared worse than eyes with SIG.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9940537 | PMC |
| http://dx.doi.org/10.4103/ijo.IJO_1475_22 | DOI Listing |
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