Uveitis surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Tarek Nafee, M.D. [2]

Overview

Surgical management of uveitis is ususally reserved for patients with complications of uveitis or in cases where patient fails to respond to medical treatment.

Surgery

There is no surgical treatment of uveitis. Surgical options are mainly reserved for management of complications or in some cases for diagnostic purposes:

Indications for surgery in uveitis

1.Therapeutic i.e visual rehabilitation:

• Surgery for removal cataract
• glaucoma
• band keratopathy
• corneal scars
• pupillary membranes
• removal of dense vitreous membranes
• vitreous heamorrhge
• retinal detachment
• chronic hypotony

2.Diagnostic:

• aqueous tap
• vitroeus
• tissue biopsy

Surgical options for Visual Rehabilitation

• Surgery for cataract impairing vision
• Surgery for Band shaped keratopathy in cases of chronic uveitis

Indications for surgery in Band shaped Keratopathy

• Juvenile idiopathic amblyopia

Diagnostic Vitrectomy

Indications for Diagnostic Vitrectomy

• Atypical clinical presentation
• Failure to response to treatment
• Strong suspicion of malignancy
• Rapidly progressive disease with inconclusive work up

Methods used for Diagnostic Vitrectomy

• Vitreous tap
• Vitreous biopsy
• Chorioretinal biopsy

Surgical management of complications of Uveitis

Glaucoma

Indications for Uveitic Glaucoma surgery

• Glaucoma resistant to medical treatment
• Acute angle closure Glaucoma

Surgical options

• Glaucoma drainage implant if there is active inflammation
• Trabeculectomy with antiproliferative agent in cases of uncontrolled IOP
• Laser peripheral Iridotomy in cases of angle closure of glaucoma

retinal detachment

Several types of Vitreo-retinal surgeries are required for various types of retinal detachment resulting as a complications of uveitis.