Intravitreal Introduction of Lucentis and Trans-Scleral Cyclophotocoagulation in the Treatment of Neovascular Glaucoma in Diabetes Mellitus

Abstract

We analyzed the results of surgical treatment of 42patients (42eyes) with neovascular glaucoma on the background of proliferative diabetic retinopathy. Intravitreal injections of anti-VEGF-drugs allow to remove newly formed vessels in anterior chamber angle, to reduce intraocular pressure, to avoid complications in patients with neovascular glaucoma and the closed anterior chamber angle of the eye. The second stage of the treatment can be laser surgery. This approach helped to reduce intraocular pressure from 28.9±0.9 to 18.5±0.9mmHg on the background of medical treatment (t>2.0; p<0.05). Visual acuity increased from 0.23±0.07 to 0.44±0.08 (t>2.0; p<0.05).In patients with NVG and closed anterior chamber angle of the eye, having aching glaucoma the use of laser surgery as the first stage of treatment allows to reduce intraocular pressure and to eliminate pain, and to apply intravitreal anti-VEGF-therapy as the second stage. The mean value of IOP decreased from 30.9±1.2 to 20.1±1.1mmHg. During the year period, the second stage (intravitreal introduction of Lucentis) was performed in all patients. As a result, IOP was reduced to 17.5±0.09mmHg. Visual acuity increased from 0.18±0.1 to 0.25±0.07 (p>0.05).