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Goniotomy may be beneficial in treating glaucoma complicating chronic uveitis
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Goniotomy is an effective, low-risk procedure for refractory glaucoma complicating chronic childhood uveitis, according to a study. It should be considered the surgical procedure of choice for this type of glaucoma, the study authors said.
Ching Lin Ho, FRCSEd, and colleagues at the Singapore National Eye Center retrospectively reviewed 54 goniotomies performed in 40 eyes of 31 patients for refractory childhood uveitic glaucoma. Success was defined as a final IOP of 21 mm Hg without medications, and qualified success was defined as an IOP of 21 mm Hg with medications.
Thirty eyes (75%) were diagnosed with juvenile rheumatoid arthritis-associated uveitis. Eleven eyes (28%) were aphakic. Mean follow-up was 98.9 months, and mean age at surgery was 10.3 years. Mean preoperative IOP was 36.7 mm Hg, and mean number of preop medications was 2.9.
Surgical success was achieved in 29 eyes (72%), including success in 22 eyes (55%) and qualified success in 7 eyes (18%). Phakic eyes, eyes with fewer peripheral anterior synechiae, patients younger than 10 years and eyes with no prior surgery had significantly better outcomes. Hyphema, usually mild and transient, occurred in 43 procedures (80%).
This study is published in the June issue of Archives of Ophthalmology.