Uveitic Flare-Ups After Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) in Patients with Uveitic Glaucoma.

IF 2.6 4区医学 Q2 OPHTHALMOLOGY

Ocular Immunology and Inflammation Pub Date : 2024-11-01 Epub Date: 2024-03-12 DOI:10.1080/09273948.2024.2316760

Raz Gepstein, Tamar Laytman Klein, Liron Naftali Ben Haim, Avner Belkin

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引用次数: 0

Abstract

Purpose: To assess the risk of gonioscopy-assisted transluminal trabeculotomy (GATT) inducing an uveitic flare-up in patients with uveitic glaucoma (UG).

Methods: This retrospective study included consecutive UG patients who underwent GATT at a single medical center between June 2020 and September 2022. The main outcome measure was the occurrence of a surgery-related uveitic complication defined as either an uveitic flare-up defined by the Standardization of Uveitis Nomenclature (SUN) criteria, or the appearance of cystoid macular edema (CME) from 2 weeks to 3 months after surgery.

Results: A total of 25 eyes of 22 patients were included in the study. Age ranged from 10-78 and 64% were women. The most common uveitic etiologies were juvenile idiopathic arthritis (JIA, 24%) and herpetic infection (24%). A total of 48%of the patients were on systemic immunosuppressants prior and unrelated to surgery. Eight eyes (32%) had severe glaucomatous damage prior to surgery, and 20% of the patients had undergone previous glaucoma surgery. Two cases (8%) demonstrated uveitic flare-up in the early postoperative period: a case of mild anterior chamber reaction and a case of CME with persistent edema prior to surgery. Average intraocular pressure (IOP) was reduced from 26.7 mm Hg on four medications to 12.2 on 1.1 after 1 year. One patient required reoperation for IOP control.

Conclusions: With careful pre and postoperative care, GATT seems to be a low-risk procedure for uveitic flare-ups in patients with UG.

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葡萄膜炎性青光眼患者接受球镜辅助透镜小梁切开术 (GATT) 后的葡萄膜炎复发。

目的：评估葡萄膜炎性青光眼（UG）患者接受球镜辅助腔内小梁切开术（GATT）诱发葡萄膜炎复发的风险：这项回顾性研究纳入了2020年6月至2022年9月期间在一家医疗中心接受GATT手术的连续UG患者。主要结果指标是手术相关葡萄膜并发症的发生情况，即根据葡萄膜炎命名标准化（SUN）标准定义的葡萄膜炎发作或术后2周至3个月出现囊样黄斑水肿（CME）：研究共纳入了 22 名患者的 25 只眼睛。年龄在 10-78 岁之间，64% 为女性。最常见的葡萄膜炎病因是幼年特发性关节炎（JIA，24%）和疱疹病毒感染（24%）。48%的患者在手术前服用过全身免疫抑制剂，但与手术无关。八只眼睛（32%）在手术前有严重的青光眼损伤，20%的患者曾接受过青光眼手术。两例（8%）患者在术后早期出现葡萄膜炎复发：一例是轻度前房反应，一例是手术前持续水肿的CME。平均眼压（IOP）从使用四种药物时的 26.7 mm Hg 降至一年后的 12.2 mm Hg，使用 1.1 种药物时的 12.2 mm Hg。一名患者需要再次手术才能控制眼压：结论：通过术前和术后的精心护理，GATT 似乎是 UG 患者葡萄膜炎复发的低风险手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ocular Immunology and Inflammation 医学-眼科学

CiteScore

6.20

自引率

15.20%

发文量

285

审稿时长

6-12 weeks

期刊介绍： Ocular Immunology & Inflammation ranks 18 out of 59 in the Ophthalmology Category.Ocular Immunology and Inflammation is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and vision scientists. Published bimonthly, the journal provides an international medium for basic and clinical research reports on the ocular inflammatory response and its control by the immune system. The journal publishes original research papers, case reports, reviews, letters to the editor, meeting abstracts, and invited editorials.