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The e-mémoires of the Académie Nationale de Chirurgie

Surgery in Uveitic Glaucoma

LEHOANG P

Seance of wednesday 08 february 2012 (LA CHIRURGIE OPHTALMOLOGIQUE)

Abstract

Uveitic glaucoma causes some of the most challenging management problems faced by the ophthalmologist. A better understanding of the pathogenesis of glaucoma associated with ocular inflammatory disease is an important key to making appropriate therapeutic decisions. Although the first choices for controlling the raise of intraocular pressure in patients with uveitic glaucoma combine the treatment of the uveitis etiology and the medical ocular hypotensive therapy, surgical therapy often becomes necessary to minimize permanent structural alteration of aqueous outflow and to prevent damage to the optic nerve head. This article provides a schematic surgical approach to the management of uveitic glaucoma according to the main mechanism responsible of the increase intraocular pressure: secondary angle closure with pupillary block glaucoma or chronic secondary open angle glaucoma. Recent developments of filtering surgery are discussed.