Glaucoma Drainage Device Surgery Outcomes in Children with Uveitic Glaucoma.
American journal of ophthalmology(2023)
Abstract
center dot PURPOSE: To evaluate outcomes of glaucoma drainage device (GDD) implantation children with uveitic glau-coma. center dot DESIGN: Retrospective interventional case series. center dot 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 crite-rion, and visual function was no perception of light or if further glaucoma surgery (excluding removal of intralu-minal stent suture or needling) was required. center dot RESULTS: Fifty eyes of 36 children with uveitic glau-coma 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 macu-lar edema (2%). Visual acuity remained stable (preoper-ation 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). center dot CONCLUSIONS: Refractory pediatric uveitic glaucoma can be treated successfully by GDD implantation. Fur-ther interventions to manage consequences of glaucoma or the underlying disease are common, and visual func-tion is maintained in the majority of cases. (Am J Oph- thalmol 2023;251: 5-11. (c) 2023 Published by Elsevier Inc.)
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