Long-Term Surgical Outcomes and Possible Postoperative Complication with Severe Corneal Endothelial Cell Loss After Trabeculectomy for Cytomegalovirus-Associated Anterior Uveitis with Secondary Glaucoma

ABSTRACT

Purpose

We assess long-term surgical outcomes after an initial trabeculectomy for cytomegalovirus-associated anterior uveitis with secondary glaucoma (CMV-SG).

Methods

We retrospectively reviewed the medical records of 16 eyes of 15 patients with CMV-SG and 157 eyes of 157 patients with primary open-angle glaucoma. The average follow-up period was approximately 3 years. Surgical success was defined as intraocular pressure (IOP) below 18 mmHg and at least 20% lower than baseline.

Results

Kaplan–Meier survival analysis revealed that bleb survival rates were not significantly different in the CMV-SG and POAG groups (P = 0.75). Bullous keratopathy occurred in 2 of 16 eyes with CMV-SG postoperatively but did not occur in the POAG group. The corneal endothelial cell density decreased by 34.2 ± 22.7% in the CMV-SG group during an average follow-up period of 2.7 ± 2.0 years.

Conclusion

Trabeculectomy effectively controlled IOP in CMV-SG, but attention must be paid to corneal endothelial cell loss.

KEYWORDS:

• Corneal endothelial cell loss
• cytomegalovirus-associated anterior uveitis
• long-term surgical outcomes
• secondary glaucoma
• trabeculectomy

Acknowledgments

The authors thank Mr. Tim Hilts for reviewing this manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval

This study was approved by the Institutional Review Board of Tohoku University Hospital (2021-1-265) and was conducted in accordance with the tenets of the Declaration of Helsinki.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/09273948.2023.2197497.