Goniosurgery effective in glaucoma secondary to uveitis

Goniosurgery can be an effective treatment for glaucoma secondary to chronic anterior uveitis, a review of cases found. The outcome of surgery was adversely influenced by patient age, by the duration of glaucoma and by the extent of peripheral anterior synechiae, among other factors, the authors found.

Ching Lin Ho, FRCSEd, and David S. Walton, MD, reviewed records of 31 eyes of 31 patients diagnosed with glaucoma secondary to chronic anterior uveitis for which 38 goniotomy procedures were performed. Success was defined as an IOP of 21 mm Hg or less; qualified success was an IOP of 21 mm Hg or less with the use of glaucoma medications postoperatively.

Overall surgical success was achieved in 22 of 31 eyes. Mean age at surgery was 10.2 years old, and mean follow-up was 10.3 years. A significant correlation was found between outcome and the patient’s age at time of surgery, lens status, glaucoma duration before gonioscopy, duration of iritis before glaucoma surgery and hours of peripheral anterior synechiae. Outcomes were not correlated with age at onset of iritis, iritis duration before glaucoma recognition, trabecular meshwork pigmentation and opacification, or narrowing of the circumferential ciliary body band.

The study is published in the December issue of Journal of Glaucoma.