Goniotomy for glaucoma econdary to chronic childhood uveiti

PURPOE: To evaluate the afety and efficacy of tandard goniotomy urgery for young patient with refractory glaucoma aociated with chronic childhood uveiti. DEIGN: Interventional cae erie. METHOD: We retropectively reviewed all goniotomie performed at our intitution for patient with a diagnoi of refractory glaucoma aociated with chronic childhood uveiti from 1994 to 2000 (thi wa our firt-line urgery for uch patient during thee year). Uveiti wa medically controlled in all cae for at leat 6 week before urgery. The main outcome meaure wa time after urgery without failure. ucce wa defined a final intraocular preure (IOP) ≤ 21 mm Hg after one or two goniotomie without need for further urgical intervention. Follow-up wa ≥6 month or until urgical failure. REULT: Nineteen goniotomie were performed on 16 eye (12 patient). Diagnoe included uveitic glaucoma aociated with juvenile rheumatoid arthriti, arcoidoi, and idiopathic uveiti. The mean patient age at firt goniotomy wa 15.3 year (range, 6.5–30), with mean follow-up 32.4 month (range, 6–84). Cae included were phakic (10 eye), aphakic (four eye), and peudophakic (two eye). The mean preoperative IOP wa 32.3 ± 4.6 mm Hg. urgical ucce wa achieved in 12 of 16 (75%) eye with a mean potoperative IOP of 12 ± 2.5 mm Hg for thee eye (mean IOP reduction, 20.0 mm Hg, P < .0001). In 10 of 16 eye (60%), urgical ucce wa achieved after a ingle goniotomy. Uveiti wa table in all patient after the early pot-operative period. ucceful eye ued, on average, 1.4 ± 1.1 glaucoma medication after goniotomy. Complication were mild and included tranient hyphema in nine cae (56%) and worening of a preexiting cataract in a ingle cae (6%). CONCLUION: Goniotomy repreent a afe and effective firt-line urgery for young patient with refractory glaucoma aociated with chronic uveiti, although the majority of patient require glaucoma medication after the procedure