Does trabeculectomy influence the course of uveitis?

It was our clinical impression that patients with uveitis who had undergone trabeculectomy had an improvement in their intraocular inflammation follow ing surgery. We undertook a retrospective review of the notes of all patien ts who underwent unaugmented trabeculectomy for uncontrolled intraocular pr essure secondary to uveitis between September 1990-July 1994, at the Uveiti s Service of the Birmingham and Midland Eye Centre, UK. The severity of the inflammation and the number of relapses post-trabeculectomy were compared to those during the pre-trabeculectomy period. A total of 32 eyes of 20 pat ients with various types of uveitis were included in the study. Mean age wa s 40 years (SD+/-2.5), range: 14-67 years, median follow-up of 53 months (S E+/-1.8), range: 33-84 months. An improvement in the pattern of uveitis pos t-trabeculectomy, defined as reduction in the severity of the inflammation and the number of relapses, was seen in 23 out of 32 (71.9%) eyes. Furtherm ore, five out of 15 patients in this group had either their systemic treatm ent stopped or the number of systemic agents reduced. Another five eyes (15 .6%) showed no change in the pattern of uveitis. The remaining four eyes (1 2.5%) suffered an increase in the number of relapses or increased severity of inflammation requiring additional treatment. It appears that trabeculect omy may have a beneficial effect on the course of uveitis. The mechanism fo r this is not clear.