Does trabeculectomy influence the course of uveitis?

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Abstract
It was our clinical impression that patients with uveitis who had undergone trabeculectomy had an improvement in their intraocular inflammation following surgery. We undertook a retrospective review of the notes of all patients who underwent unaugmented trabeculectomy for uncontrolled intraocular pressure secondary to uveitis between September 1990-July 1994, at the Uveitis Service of the Birmingham and Midland Eye Centre, UK. The severity of the inflammation and the number of relapses post-trabeculectomy were compared to those during the pre-trabeculectomy period. A total of 32 eyes of 20 patients with various types of uveitis were included in the study. Mean age was 40 years (SD+/-2.5), range: 14-67 years, median follow-up of 53 months (SE+/-1.8), range: 33-84 months. An improvement in the pattern of uveitis post-trabeculectomy, defined as reduction in the severity of the inflammation and the number of relapses, was seen in 23 out of 32 (71.9%) eyes. Furthermore, five out of 15 patients in this group had either their systemic treatment stopped or the number of systemic agents reduced. Another five eyes (15.6%) showed no change in the pattern of uveitis. The remaining four eyes (12.5%) suffered an increase in the number of relapses or increased severity of inflammation requiring additional treatment. It appears that trabeculectomy may have a beneficial effect on the course of uveitis. The mechanism for this is not clear.