Risk factors for glaucoma surgery secondary to childhood uveitis

Purpose To identify risk factors for medically uncontrollable high intraocular pressure (IOP) secondary to uveitis in children. Methods Patients diagnosed with uveitis before their 18th birthday and with a minimal follow‐up of one year were included from the ophthalmology departments of the University Medical Center Groningen and the University Medical Center Utrecht in a retrospective case‐control study. Results A total of 196 patients were included, 85 of whom had undergone glaucoma surgery. Compared to the non‐surgery group at onset of uveitis, patients in the surgery group were younger (median age 6 vs 8 years, p = 0.008), uveitis was more often located anteriorly (78% vs 62%, p = 0.02), and was predominantly associated with JIA (62% vs 35%, p < 0.001). During follow‐up, patients in the surgery group had higher maximum IOPs (IOP 37 mmHg vs 27 mmHg, p < 0.001) and more often used >2 types of glaucoma medication (83% vs 24%, p < 0.001). Gender, bilaterality, visual acuity and ocular complications at diagnosis, ANA positivity, use of systemic immune‐suppression, and cataract surgery before glaucoma surgery were not significantly different between the two groups. Cox survival analysis showed that anterior uveitis and increased IOP at presentation were predictive of increased risk of needing glaucoma surgery. Conclusion Anterior location of the uveitis and higher IOP at presentation are associated with an increased risk of glaucoma surgery. Patients who need >2 types of glaucoma medication are likely to need glaucoma surgery.