Outcome of trabeculectomy with intraoperative mitomycin C for uveitic glaucoma.

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]<or=30% baseline without glaucoma medications or 5-fluorouracil (5-FU) injections), and qualified success (IOP<or=30% baseline with glaucoma medications or 5-FU injections). Kaplan-Meier survival curves were constructed for both models.

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.