Visual Function and Intraocular Pressure Outcomes Following Surgical Intervention in Pediatric Patients with Inflammatory Glaucoma.

Abstract

Purpose: This study evaluates the outcomes of pediatric uveitic glaucoma eyes that received surgery compared to non-surgical pediatric uveitis eyes.

Methods: A retrospective chart review was performed of patients diagnosed with inflammatory glaucoma before the age of 18 years. Outcomes, including intraocular pressure (IOP), visual acuity (VA), and inflammatory activity were assessed over two years.

Results: Thirty-six eyes (18 surgically managed, 18 non-surgical) were included in this study. At baseline the surgical eyes had significantly higher median IOP than the non-surgical pediatric uveitis eyes (31.5 mmHg versus 15.0 mmHg; p < 0.001). Two years later, the median IOP between the surgical eyes and non-surgical eyes was not significantly different (12.0 mmHg versus 13.5 mmHg; p = 0.14). Median visual acuity (VA) was not significantly different between surgically managed eyes (logMAR 0.35 [IQR: 0.10-0.50] and non-surgical eyes 0.10 [IQR: 0.03-0.85]; p = 0.92) at baseline. At two years, the median VA in surgical eyes improved to 0.30 (IQR: 0.12-0.70), while the non-surgical eyes maintained a stable median VA of 0.10 (IQR: 0.00-0.20). The mean number of glaucoma medications in the surgical eyes decreased considerably from 3.2 ± 1.6 medications at baseline to 0.67 ± 1.1 at two years.

Conclusion: Our data showcases that glaucoma surgery in patients with well controlled uveitis, can provide significant benefit to patients that are refractory to medical management, by reducing IOP and glaucoma medication burden, with excellent visual outcomes at two years.