Combined fluocinolone implant and glaucoma surgery shows promise in eyes with uveitis and glaucoma

Researchers retrospectively evaluated five patients (seven eyes) with uveitis and elevated IOP who underwent combined fluocinolone acetonide implantation and glaucoma tube shunt placement in a single surgery.  All subjects had chronic noninfectious intermediate or posterior uveitis and elevated IOP while receiving maximum tolerated medical therapy

The average number of recurrences 12 months before implantation was three episodes per eye. Of the three eyes followed up for more than 30 months, none had an inflammatory recurrence within 30 months after implantation. Mean visual acuity 12 months after surgery was 20/114, compared with 20/400 at baseline. Adjunctive steroid use decreased. Average IOP decreased from 27.3 mm Hg at baseline to 14.6 mm Hg 12 months after surgery (P = .019).

Since control of uveitis may result in a lowering of IOP, it would be useful to compare the combined procedure with fluocinolone acetonide alone in a patient with bilateral eye involvement requiring the treatment for uveitis and raised IOP in both eyes. The authors present a small series of eyes, but the results suggest a promising method for the treatment of a difficult management problem in ophthalmology.