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

PURPOSE: To determine the long-term success rate after trabeculectomy witho ut antimetabolites in patients with uveitis. METHODS: Review of data from all patients with uveitis who underwent trabec ulectomy for uncontrolled intraocular pressure secondary to intraocular inf lammation between May 1990 and December 1994. Results were compared with th ose from a group of patients with primary open-angle glaucoma matched for s ex and surgeon. RESULTS: The uveitis group consisted of 32 eyes (20 patients), Maximum cont rol of intraocular inflammation was achieved for a minimum of 2 months befo re surgery. Mean (+/- SD) age was 40.0 +/- 12.5 years (range, 14 to 67 year s), with a median (+/- SE) follow up of 53.0 +/- 1.8 months (range, 33 to 8 4 months). The primary open-angle glaucoma group consisted of 33 eyes (23 p atients), with a mean age of 62.0 +/- 13.7 years (range, 26 to 81 years) an d 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% co mpared with 82% for the primary open-angle glaucoma group (P = .7). The abs olute 5-year success rate (in traocular pressure less than or equal to 21 m m Hg with no medication) for the uveitis group was 53% compared with 67% fo r the primary open-angle glaucoma group (P = .87). CONCLUSIONS: In the absence of other risk factors, such as Afro-Caribbean r ace and previous intraocular surgery, and with adequate preoperative contro l of inflammation, trabeculectomy without antimetabolites may be considered the primary surgical procedure for increased intraocular pressure in patie nts with uveitis, (Am J Ophthalmol 1999;128:434-439. (C) 1999 by Elsevier S cience Inc. All rights reserved.).