Initial trabeculectomy with mitomycin C in eyes with uveitic glaucoma with inactive uveitis

Purpose To analyse clinical outcomes of trabeculectomy with mitomycin C (MMC) in eyes with uveitic glaucoma (UG) with inactive uveitis and compare them to those in eyes with primary open-angle glaucoma (POAG). Design Retrospective non-randomized comparative interventional case series. Methods A total of 53 eyes with UG and 80 eyes with POAG that received MMC trabeculectomy as an initial ocular surgery with average follow-up of 5.4 years were reviewed retrospectively. The intraocular pressure (IOP) control and persistence of filtering bleb were analysed using the Kaplan-Meier life-table method based on two definitions of successful IOP control, ie complete success (IOP <= 15 mm Hg without anti-glaucoma medications) and qualified success (IOP <= 15 mm Hg with topical anti-glaucoma medications). The incidences of postoperative complications were also examined. Results Complete success rate for postoperative IOP control at 5 years after trabeculectomy was 57.1 +/- 7.5% (mean +/- SE) in UG, being comparable to that in POAG (53.7 +/- 6.1%), and those of qualified success was 64.7 +/- 7.0 and 65.9 +/- 5.5% (P=0.60 and 0.53) respectively. Persistence of filtrating blebs was shorter in UG than in POAG (P=0.031). Postoperative inflammation in UG was associated with worse postoperative IOP control and loss of filtering bleb (P=0.027 and 0.021). Postoperative long-standing ocular hypotony was more frequent in UG (P=0.0063). Conclusions An MMC trabeculectomy for UG with inactive uveitis as an initial ocular surgery had IOP control comparable to that for POAG, suggesting that pre-existing uveitis itself is not a risk factor for failure of a filtering surgery. Eye (2009) 23, 1509-1517; doi:10.1038/eye.2009.117; published online 12 June 2009