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Initial Trabeculectomy With Mitomycin-C for Secondary Glaucoma-associated With Uveitis in Behçet Disease Patients

Komae, Keiko MD*; Takamoto, Mitsuko MD, PhD*; Tanaka, Rie MD*; Aihara, Makoto MD, PhD*; Ohtomo, Kazuyoshi MD*; Okinaga, Kimiko MD, PhD*; Matsuda, Junko MD*; Nakahara, Hisae MD*; Fujino, Yujiro MD, PhD; Kaburaki, Toshikatsu MD, PhD*

doi: 10.1097/IJG.0000000000000665
Original Studies
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Purpose: To examine clinical outcomes following an initial trabeculectomy with mitomycin-C for secondary glaucoma associated with uveitis in Behçet disease (BD) patients.

Design: Retrospective interventional case series.

Patients and Methods: Twenty-two eyes in 18 patients with uveitic glaucoma (UG) associated with Behçet disease who underwent an initial trabeculectomy with mitomycin-C between January 1996 and August 2014 were retrospectively reviewed. The main outcome measures were intraocular pressure (IOP) control, persistence of a filtering bleb, incidence of postoperative complications, and preopertaive and postoperative frequency of uveitic attacks. We analyzed persistence rates using Kaplan-Meier life tables based on 3 definitions of target IOP control (≤21, ≤18, ≤15 mm Hg) and filtering bleb persistence.

Result: The persistence rates of postoperative IOP at ≤21, ≤18, and ≤15 mm Hg at 5 years after surgery were 76.1%, 71.5%, and 68.1%, respectively, whereas that of a filtering bleb was 54.4%. Hypotony as a postoperative complication was observed in 4 (18.2%) cases. No significant difference was observed between the preoperative and postoperative frequency of uveitic attacks (1.36±1.15 vs. 0.95±1.49 times/y, P=0.16). There was 1 case in which recurrence of uveitis after surgery caused a loss of filtering bleb, which required a reoperation.

Conclusions: At 5 years after surgery, the persistence rate of postoperative IOP control (≤21 mm Hg) was 76.1% and that of a filtering bleb was 54.4%. The frequency of uveitis recurrence did not significantly increase after surgery. Attention must be paid to avoid such recurrence to maintain the filtering bleb.

*Department of Ophthalmology, University of Tokyo School of Medicine

Department of Ophthalmology, Japan Community Health Care Organization Tokyo Shinjuku Center, Tokyo, Japan

Supported in part by a Grant-in-Aid for Science Research for Behçet’s disease from the Ministry of Health, Labor and Welfare of Japan.

Disclosure: The authors declare no conflict of interest.

Reprints: Keiko Komae, MD, Department of Ophthalmology, University of Tokyo School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 Japan (e-mail: cappuccino_sweets@yahoo.co.jp).

Received October 11, 2015

Accepted February 27, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.