Phacoemulsification after trabeculectomy in uveitis associated with Vogt-Koyanagi-Harada disease: intermediate-term visual outcome, IOP control and trabeculectomy survival

Abstract Purpose To evaluate the visual outcome, intraocular pressure control and trabeculectomy survival after phacoemulsification in eyes with prior trabeculectomy in uveitis associated with Vogt-Koyanagi-Harada disease (VKH). Design Retrospective comparative study. Methods Eyes with uveitic glauc...

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Main Authors: Faisal A. Almobarak, Ali H. Alharbi, Ibrahim Aljadaan, Hassan Aldhibi
Format: Article
Language:English
Published: BMC 2022-05-01
Series:BMC Ophthalmology
Subjects:
Online Access:https://doi.org/10.1186/s12886-022-02438-3
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author Faisal A. Almobarak
Ali H. Alharbi
Ibrahim Aljadaan
Hassan Aldhibi
author_facet Faisal A. Almobarak
Ali H. Alharbi
Ibrahim Aljadaan
Hassan Aldhibi
author_sort Faisal A. Almobarak
collection DOAJ
description Abstract Purpose To evaluate the visual outcome, intraocular pressure control and trabeculectomy survival after phacoemulsification in eyes with prior trabeculectomy in uveitis associated with Vogt-Koyanagi-Harada disease (VKH). Design Retrospective comparative study. Methods Eyes with uveitic glaucoma associated with VKH who underwent mitomycin C (MMC)-enhanced trabeculectomy were included. Eyes were divided into two groups: the first study group included eyes that later underwent cataract surgery in the form of phacoemulsification, and the second control group included eyes that did not have cataract surgery. The main outcome measures were changes in the visual acuity, intraocular pressure (IOP), the number of antiglaucoma medications, IOP control and trabeculectomy survival. Results There were no significant differences in the final visual acuity (0.78 (±0.9) and 0.92 (±1.1), p = 0.80)) nor IOP (14.21 mmHg (±5.8) and 12.16 mmHg (±6.1), p = 0.29), but there was a difference in the antiglaucoma medications (1.58 (±1.5) and 0.53 (±1.0), p = 0.02) between the study and control group, respectively. There was no difference in the overall trabeculectomy survival (p = 0.381, Log Rank), but more eyes in the study group converted to qualified success after phacoemulsification and required more medications to control the IOP. Conclusion Phacoemulsification after trabeculectomy seems to be a safe procedure in eyes with combined vision threatening complications of VKH, although the visual improvement was limited. Nevertheless, more medications were required to control the IOP, resulting in less absolute and more qualified trabeculectomy success. Therefore, patient counseling before surgery is essential.
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spelling doaj.art-3c8cfd2920cd49bbb0f2ec5d3b0a97e72022-12-22T00:40:53ZengBMCBMC Ophthalmology1471-24152022-05-012211810.1186/s12886-022-02438-3Phacoemulsification after trabeculectomy in uveitis associated with Vogt-Koyanagi-Harada disease: intermediate-term visual outcome, IOP control and trabeculectomy survivalFaisal A. Almobarak0Ali H. Alharbi1Ibrahim Aljadaan2Hassan Aldhibi3Department of Ophthalmology, College of medicine, King Saud UniversityGlaucoma Division, King Khaled Eye Specialist HospitalGlaucoma Division, King Khaled Eye Specialist HospitalUveitis Division, King Khaled Eye Specialist HospitalAbstract Purpose To evaluate the visual outcome, intraocular pressure control and trabeculectomy survival after phacoemulsification in eyes with prior trabeculectomy in uveitis associated with Vogt-Koyanagi-Harada disease (VKH). Design Retrospective comparative study. Methods Eyes with uveitic glaucoma associated with VKH who underwent mitomycin C (MMC)-enhanced trabeculectomy were included. Eyes were divided into two groups: the first study group included eyes that later underwent cataract surgery in the form of phacoemulsification, and the second control group included eyes that did not have cataract surgery. The main outcome measures were changes in the visual acuity, intraocular pressure (IOP), the number of antiglaucoma medications, IOP control and trabeculectomy survival. Results There were no significant differences in the final visual acuity (0.78 (±0.9) and 0.92 (±1.1), p = 0.80)) nor IOP (14.21 mmHg (±5.8) and 12.16 mmHg (±6.1), p = 0.29), but there was a difference in the antiglaucoma medications (1.58 (±1.5) and 0.53 (±1.0), p = 0.02) between the study and control group, respectively. There was no difference in the overall trabeculectomy survival (p = 0.381, Log Rank), but more eyes in the study group converted to qualified success after phacoemulsification and required more medications to control the IOP. Conclusion Phacoemulsification after trabeculectomy seems to be a safe procedure in eyes with combined vision threatening complications of VKH, although the visual improvement was limited. Nevertheless, more medications were required to control the IOP, resulting in less absolute and more qualified trabeculectomy success. Therefore, patient counseling before surgery is essential.https://doi.org/10.1186/s12886-022-02438-3GlaucomaUveitisTrabeculectomyCataractVogt-Koyanagi-Harada disease
spellingShingle Faisal A. Almobarak
Ali H. Alharbi
Ibrahim Aljadaan
Hassan Aldhibi
Phacoemulsification after trabeculectomy in uveitis associated with Vogt-Koyanagi-Harada disease: intermediate-term visual outcome, IOP control and trabeculectomy survival
BMC Ophthalmology
Glaucoma
Uveitis
Trabeculectomy
Cataract
Vogt-Koyanagi-Harada disease
title Phacoemulsification after trabeculectomy in uveitis associated with Vogt-Koyanagi-Harada disease: intermediate-term visual outcome, IOP control and trabeculectomy survival
title_full Phacoemulsification after trabeculectomy in uveitis associated with Vogt-Koyanagi-Harada disease: intermediate-term visual outcome, IOP control and trabeculectomy survival
title_fullStr Phacoemulsification after trabeculectomy in uveitis associated with Vogt-Koyanagi-Harada disease: intermediate-term visual outcome, IOP control and trabeculectomy survival
title_full_unstemmed Phacoemulsification after trabeculectomy in uveitis associated with Vogt-Koyanagi-Harada disease: intermediate-term visual outcome, IOP control and trabeculectomy survival
title_short Phacoemulsification after trabeculectomy in uveitis associated with Vogt-Koyanagi-Harada disease: intermediate-term visual outcome, IOP control and trabeculectomy survival
title_sort phacoemulsification after trabeculectomy in uveitis associated with vogt koyanagi harada disease intermediate term visual outcome iop control and trabeculectomy survival
topic Glaucoma
Uveitis
Trabeculectomy
Cataract
Vogt-Koyanagi-Harada disease
url https://doi.org/10.1186/s12886-022-02438-3
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