In a retrospective interventional cohort study, the findings of which were recently published in the American Journal of Ophthalmology, the researchers sought to determine the visual outcomes and effectiveness of glaucoma surgery in patients with congenital ectropion uvea.
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In this study, surgical findings and examination of 11 eyes (8 patients) with congenital ectropion uvea were collected. The research was conducted at two academic sites and between the years 2001-2021. The researchers evaluated visual outcomes, surgical success (intraocular pressure [IOP] – 5-20 mm Hg, the absence of the need for additional surgery to lower eye pressure, and the absence of devastating visual complications), and the survival rates of glaucoma surgeries.
The results of the study demonstrated that bilateral ectropion uvea patients are diagnosed with glaucoma at a younger age (0.02 ± 0.01 years) compared to unilateral disease (8.9 ± 5.3 years, P=.002). All eyes required glaucoma surgery. 91% even required multiple surgeries (3.5 ± 2.1, median of 3 surgeries per eye). Therapeutic success was demonstrated in 13% of trabeculotomy operations (8 eyes). Although none of the four eyes that underwent trabeculectomy with mitomycin C required reoperation, drainage device placement, or cycloablation, 75% ultimately required filter bed (bleb) repair surgery. Glaucoma drainage devices (7 eyes) had a 57% success rate, with 3 eyes requiring cyclovalvation (2) or trabeculectomy (1). At final follow-up (8.5 ± 6.6 years, median: 7.9 years), all eyes achieved IOP control, with lower IOP compared with baseline (13.2 ± 2.6 mmHg vs. 32.9 ± 9.9 mmHg, P=.002 ). At the final follow-up, the best corrected logarithm of the minimum angle for visual acuity was 0.2 ± 0.2.
The results of the study show that compared to unilateral disease, patients with bilateral congenital ectropion uvea present with glaucoma at a younger age. The results of the study revealed that most eyes required multiple glaucoma surgeries. Angle surgery has been shown to be less effective than trabeculectomy and glaucoma drainage devices. IOP control was achieved in all eyes, with good results.
source:
Jacobson, A., Moroi, S. E., & Bohnsack, B. L. (2022). Characteristics and outcomes of glaucoma associated with congenital ectropion uvea. American Journal of Ophthalmology, 2411-8.