Long-term follow-up of trabeculectomy without antimetabolites in patients with uveitis

PURPOSE: To determine the long-term success rate after trabeculectomy without antimetabolites in patients with uveitis. METHODS: Review of data from all patients with uveitis who underwent trabeculectomy for uncontrolled intraocular pressure secondary to intraocular inflammation between May 1990 and December 1994. Results were compared with those from a group of patients with primary open-angle glaucoma matched for sex and surgeon. RESULTS: The uveitis group consisted of 32 eyes (20 patients), Maximum control of intraocular inflammation was achieved for a minimum of 2 months before surgery. Mean (+/- SD) age was 40.0 +/- 12.5 years (range, 14 to 67 years), with a median (+/- SE) follow up of 53.0 +/- 1.8 months (range, 33 to 84 months). The primary open-angle glaucoma group consisted of 33 eyes (23 patients), with a mean age of 62.0 +/- 13.7 years (range, 26 to 81 years) and a median follow-up of 63.0 +/- 12.0 months (range, 34 to 299 months). The overall 5-year success rate (intraocular pressure less than or equal to 21 mm Hg with or without topical medication) for the uveitis group was 78% compared with 82% for the primary open-angle glaucoma group (P = .7). The absolute 5-year success rate (in traocular pressure less than or equal to 21 mm Hg with no medication) for the uveitis group was 53% compared with 67% for the primary open-angle glaucoma group (P = .87). CONCLUSIONS: In the absence of other risk factors, such as Afro-Caribbean race and previous intraocular surgery, and with adequate preoperative control of inflammation, trabeculectomy without antimetabolites may be considered the primary surgical procedure for increased intraocular pressure in patients with uveitis, (Am J Ophthalmol 1999;128:434-439. (C) 1999 by Elsevier Science Inc. All rights reserved.).