Uveitis surgery: Difference between revisions

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{{Uveitis}}
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==Overview==
==Overview==
There is no  indication for surgical intervention in uveitis. Surgical management of uveitis is most commonly reserved for management of complications of uveitis or, rarely, for diagnostic purposes. Common complications of uveitis requiring surgery include [[cataract surgery]], [[glaucoma surgery]], or [[band keratopathy]]. Common indications for the diagnostic utility of surgery in uveitis include [[vitreous]] tap, [[vitreous]] biopsy, and posterior uveal biopsy.<ref name="pmid: PMC3744781">{{cite journal| author=Katzav S, Shapiro J, Segal S, yM| title=General nesthesia during excision of a mouse tumor accelerates postsurgical growth of metastases by suppression of natural killer cell activity. | journal=Isr J Med Sci | year= 1986 | volume= 22 | issue= 5 | pages= 339-45 | pmid=: PMC3744781 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pu bmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3744781  }} </ref>
==Surgery==
==Surgery==
There are several surgical options for treatment of uveitis based on following indications:<ref name="pmid: PMC3744781">{{cite journal| author=Katzav S, Shapiro J, Segal S, Feldman M| title=General anesthesia during excision of a mouse tumor accelerates postsurgical growth of metastases by suppression of natural killer cell activity. | journal=Isr J Med Sci | year= 1986 | volume= 22 | issue= 5 | pages= 339-45 | pmid=: PMC3744781 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3744781  }} </ref>
There is no surgical treatment of uveitis. Surgical options are most commonly reserved for management of complications or rarely for diagnostic purposes:<ref name="pmid: PMC3744781">{{cite journal| author=Katzav S, Shapiro J, Segal S, yM| title=General nesthesia during excision of a mouse tumor accelerates postsurgical growth of metastases by suppression of natural killer cell activity. | journal=Isr J Med Sci | year= 1986 | volume= 22 | issue= 5 | pages= 339-45 | pmid=: PMC3744781 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pu bmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3744781  }} </ref>
*Indications:
===Indications for surgery in uveitis===
**Therapeutic i.e visual rehabilitation: Surgery for removal of [[cataract]], [[band keratopathy]], corneal scars, [[pupillary membranes]], [[removal of dense vitreous membranes]].
The primary indications for surgery in uveitis include management of complications and diagnostic procedures.
**Diagnostic: aqueous tap, vitroeus biopsy, tissue biopsy
====Management of Complications====  
**Management of complications: Surgery for [[glaucoma]],  [[vitreous hemorrhage]], [[retinal detachment]] and chronic hypotony.
The following surgical procedures may be performed to manage the following complications of uveitis:
===Surgical options for Visual Rehabilitation===
*[[Cataract surgery]]
'''Indications for cataract surgery'''
*[[Glaucoma surgery]]  
*Phaco-antigenic uveitis: leakage of lens protein resulting in inflammation
*[[Band keratopathy]]  
*Cataract impairing vision
*Corneal scars
*Cataract impairing posterior segment visualisation: cases of retinal neovascularisation, retino-choroidal pathology or patient undergoing vitreo-retinal
*[[Pupillary membranes]]  
surgery.
*Removal of dense [[vitreous]] membranes
 
*[[Vitreous hemorrhage]]
'''Surgical options for cataract surgery'''
*[[Retinal detachment]]  
*Phacoemulsification
*Chronic hypotony
*Extracapsular cataract extraction
*Posterior chamber intraocular lens implantation
'''Indications for surgery in Band shaped [[Keratopathy]]'''
*Juvenile idiopathic [[amblyopia]]
'''Surgical options in Band Shaped Keratopathy'''
*Phototherapeutic [[keratectomy]]
*Chemical chelation with [[EDTA]]
*Superficial [[keratectomy]] with or without adjuvent [[amniotic membrane transplant]]
 
===Surgical options for Diagnostic purposes===


== Diagnostic [[Vitrectomy]]==
====Diagnostic====
'''Indications for Diagnostic [[Vitrectomy]]'''
Indications for surgical diagnostic procedures in uveitis include:
*Atypical clinical presentation
*Atypical clinical presentations
*Failure to response to treatment
*Failure to respond to treatment
*Strong suspicion of [[malignancy]]
*Strong suspicion of [[malignancy]]
*Rapidly progressive disease with inconclusive work up
*Rapidly progressive disease with inconclusive work up
'''Methods used for Diagnostic Vitrectomy'''
Surgical options used for diagnostic purposes may include:
*[[Vitreous]] tap
*[[Vitreous]] tap
*[[Vitreous]] biopsy
*[[Vitreous]] [[biopsy]]
*[[Chorioretinal]] 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.


==Reference==
==Reference==
{{reflist|2}}
{{reflist|2}}


 
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[[Category:Ophthalmology]]
[[Category:Ophthalmology]]
[[Category:Primary care]]
[[Category:FinalQCRequired]]
 
[[Category:Emergency mdicine]]
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[[Category:Up-To-Date]]
[[Category:Infectious disease]]

Latest revision as of 00:37, 30 July 2020

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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

There is no indication for surgical intervention in uveitis. Surgical management of uveitis is most commonly reserved for management of complications of uveitis or, rarely, for diagnostic purposes. Common complications of uveitis requiring surgery include cataract surgery, glaucoma surgery, or band keratopathy. Common indications for the diagnostic utility of surgery in uveitis include vitreous tap, vitreous biopsy, and posterior uveal biopsy.[1]

Surgery

There is no surgical treatment of uveitis. Surgical options are most commonly reserved for management of complications or rarely for diagnostic purposes:[1]

Indications for surgery in uveitis

The primary indications for surgery in uveitis include management of complications and diagnostic procedures.

Management of Complications

The following surgical procedures may be performed to manage the following complications of uveitis:

Diagnostic

Indications for surgical diagnostic procedures in uveitis include:

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

Surgical options used for diagnostic purposes may include:

Reference

  1. 1.0 1.1 Katzav S, Shapiro J, Segal S, yM (1986). bmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3744781 "General nesthesia during excision of a mouse tumor accelerates postsurgical growth of metastases by suppression of natural killer cell activity" Check |url= value (help). Isr J Med Sci. 22 (5): 339–45. PMID PMC3744781 : PMC3744781 Check |pmid= value (help).

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