Uveitic Glaucoma Follow-up

Updated: May 03, 2017
  • Author: Leon Herndon, Jr, MD; Chief Editor: Inci Irak Dersu, MD, MPH  more...
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Follow-up

Further Outpatient Care

Patients should receive follow-up care as needed.

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Inpatient & Outpatient Medications

See Medication.

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Complications

Complications of uveitis include the following:

  • Band keratopathy
  • Corneal decompensation
  • Posterior subcapsular cataract
  • Vitreous opacities
  • Retinal or choroidal detachment
  • Macular edema
  • Disc edema

Postoperative complications include the following:

  • Postoperative complications (eg, choroidal effusion, choroidal hemorrhage, shallow anterior chamber, hypotony) may be higher in eyes with uveitic glaucoma than with primary open-angle glaucoma after trabeculectomy with wound modulation.
  • Postoperative inflammation is fairly common in eyes with uveitic glaucoma, although this incidence can be lowered by treating the patients with preoperative and postoperative corticosteroids.
  • The combination of postoperative inflammation and shallow anterior chamber can lead to the formation of PAS, which may interfere with the function of the glaucoma filter. Cataract formation also is very common with this scenario; therefore, prolonged periods of postoperative shallowing of the anterior chamber should be avoided.
  • Phthisis bulbi may occur after any surgical procedure for uveitic glaucoma but is particularly common after cycloablative therapy. Eyes that may be at high risk of developing phthisis include those with a totally occluded angle and a relatively low preoperative IOP.
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Prognosis

Few published reports are available that address the results of surgery in patients with uveitic glaucoma.

Hoskins et al achieved successful lowering of IOP in 6 of 9 eyes undergoing trabeculectomy for uveitic glaucoma. [12]

Hill et al showed a success rate of 81% at 12 months. The success rate of trabeculectomy with antimetabolite supplementation has been reported to be higher (71-100%). [13]

Wright et al reported that 3 of 24 patients undergoing trabeculectomy with mitomycin-C required subsequent drainage implants and that 7 of 24 patients lost 2 or more lines of Snellen acuity. [14]

Hill et al reported a success rate of 79% of eyes undergoing Molteno tube implantation. [15]

Ceballos et al reported a success rate of 91.7% in eyes undergoing Baerveldt drainage device placement for uveitic glaucoma. [16]

Ozdal et al showed a 2-year success rate of 60% in eyes undergoing Ahmed drainage device placement for uveitic glaucoma. [17]

Rachmiel et al reported similar 30-month results between eyes that underwent Ahmed glaucoma valve implantation with uveitic glaucoma compared to open-angle glaucoma eyes. [18]

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Patient Education

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