Surgical Glaucoma Treatment in Patients with Juvenile Idiopathic Arthritis-Associated Uveitis: Results after Trabeculectomy or Ahmed Glaucoma Valve Implantation

Ocul Immunol Inflamm. 2024 Jul;32(5):636-641. doi: 10.1080/09273948.2023.2185263. Epub 2023 Mar 10.

Abstract

Purpose: Patients with juvenile idiopathic arthritis (JIA) associated uveitis (JIAU) are at risk for secondary glaucoma, frequently requiring surgical management. We compared the success rates for trabeculectomy (TE) and Ahmed glaucoma valve (AGV) implantation.

Methods: We conducted a retrospective analysis of TE (45 eyes), primary AGV (pAGV) (7 eyes), or secondary AGV (sAGV) implantation after TE (11 eyes) in JIAU at the 2-year follow-up.

Results: All groups achieved significant pressure reduction. After 1 year, the overall success rate was higher in the Ahmed groups (p = 0.03). After adjusting the p-value according to Benjamin Hochberg, there is no significant difference between the groups in the Kaplan-Meier, despite a significant logrank test between all groups (p = 0.0194) and a better performance in the Ahmed groups.

Conclusion: Slightly better success rates were achieved with pAGV in managing JIAU patients with glaucoma refractory to medical treatment.

Keywords: Ahmed glaucoma valve; glaucoma; juvenile idiopathic arthritis; trabeculectomy; uveitis.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Arthritis, Juvenile* / complications
  • Arthritis, Juvenile* / surgery
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Glaucoma Drainage Implants*
  • Glaucoma* / etiology
  • Glaucoma* / physiopathology
  • Glaucoma* / surgery
  • Humans
  • Intraocular Pressure* / physiology
  • Male
  • Prosthesis Implantation
  • Retrospective Studies
  • Trabeculectomy* / methods
  • Treatment Outcome
  • Uveitis* / complications
  • Uveitis* / diagnosis
  • Uveitis* / etiology
  • Uveitis* / surgery
  • Visual Acuity* / physiology
  • Young Adult