Glaucoma Drainage Device Surgery Outcomes in Children With Uveitic Glaucoma.
Am J Ophthalmol
; 251: 5-11, 2023 07.
Article
em En
| MEDLINE
| ID: mdl-36822573
ABSTRACT
PURPOSE:
To evaluate outcomes of glaucoma drainage device (GDD) implantation children with uveitic glaucoma.DESIGN:
Retrospective interventional case series.METHODS:
Success was defined as intraocular pressure (IOP) ≥5 and ≤21 mm Hg. Failure was defined at final follow-up when the IOP was outside the success criterion, and visual function was no perception of light or if further glaucoma surgery (excluding removal of intraluminal stent suture or needling) was required.RESULTS:
Fifty eyes of 36 children with uveitic glaucoma underwent GDD implantation. Mean age at surgery was 10.1±3.1 years (range 5-17) with a mean follow-up of 113±61 months (range 8-228). Mean cumulative probabilities of success (95% CI) were 0.98 (0.86-1.00) at 1 year, 0.87 (0.73-0.94) at 5 years, and 0.59 (0.32-0.78) at 15 years. Fourteen tubes were classified as failed, with 12 due to uncontrolled IOP (11 eyes required a second GDD); 1 eye, removal of the tube due to plate exposure; and 1 eye, lost light perception. Postoperative complications occurred in 36% of patients and included hypotony (22%), tube exposure (6%), tube obstruction (4%), corneal decompensation (2%), and cystoid macular edema (2%). Visual acuity remained stable (preoperation 0.35±0.42 vs postoperation 0.45±0.67, P = .49). IOP was significantly reduced from 31.4±7.5 mm Hg to 14.4±5.1 mm Hg (P < .0001) as were the number of glaucoma medications 3.5±1.0 vs 1.1±1.3 (P < .0001).CONCLUSIONS:
Refractory pediatric uveitic glaucoma can be treated successfully by GDD implantation. Further interventions to manage consequences of glaucoma or the underlying disease are common, and visual function is maintained in the majority of cases.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Glaucoma
/
Implantes para Drenagem de Glaucoma
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Child
/
Humans
/
Infant
Idioma:
En
Revista:
Am J Ophthalmol
Ano de publicação:
2023
Tipo de documento:
Article