Treatment of Uveitis and Outcomes of Glaucoma Drainage Implant Surgery: A Meta-Analysis

Ocul Immunol Inflamm. 2020 Jul 3;28(5):833-838. doi: 10.1080/09273948.2019.1629602. Epub 2019 Aug 16.

Abstract

Purpose: We performed a meta-analysis to evaluate the effect of uveitis treatment on glaucoma drainage implant surgical outcomes.

Methods: We included 16 articles in the meta-analysis. Two groups were defined based on medical therapy of uveitis: Group 1: poorly controlled uveitis, and Group 2: well-controlled uveitis including use of immunomodulatory medications.

Results: The two groups were similar in comparisons of follow-up time, age, gender, and etiology of uveitis. Meta-analysis demonstrated significantly greater success in Group 2 (95.1%) compared to Group 1 (81.6%) at 1 year after glaucoma drainage implant surgery (P = .001). The final success was significantly greater (P 0.014) in group 2 compared with group 1 (86.1% and 74.3%, respectively).

Conclusion: Surgical success was significantly higher in uveitic glaucoma patients treated with more intensive immunosuppressive therapy before and after glaucoma drainage implant surgery. The level of control of uveitis perioperatively appears to influence glaucoma drainage implant surgery outcomes.

Keywords: Glaucoma drainage implant; glaucoma surgical outcomes; immunomodulatory therapy; meta-analysis; uveitic glaucoma.

Publication types

  • Meta-Analysis

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Glaucoma / etiology
  • Glaucoma / physiopathology*
  • Glaucoma / surgery*
  • Glaucoma Drainage Implants*
  • Humans
  • Immunomodulation*
  • Intraocular Pressure / physiology*
  • Male
  • Middle Aged
  • Treatment Outcome
  • Uveitis / complications
  • Uveitis / drug therapy*
  • Visual Acuity / physiology