Pars plana vitrectomy and panretinal photocoagulation combined with trabeculectomy for successful treatment of neovascular glaucoma

Abstract

Complete PRP combined with trabeculectomy with MMC can effectively reduce the elevated IOP in eyes with NVG. However, this combined treatment is not effective in eyes with proliferative membranes and retinal detachments.

Adjunctive Intravitreal Bevacizumab-Combined Trabeculectomy Versus Trabeculectomy Alone in the Treatment of Neovascular Glaucoma

“…Overall visual outcomes in the ivBe group are acceptable or better than those previously reported. 26,27 A large case series of 32 patients whose aggressive surgeries included vitrectomy with cyclophotocoagulation and silicone oil tamponade to treat uncontrolled NVG showed worse visual acuity than hand movements in 69% of eyes at months, and 31% Intravitreal bevacizumab, a VEGF inhibitor, provides a specifi c pharmacologic inhibitor of a primary mediator of anterior segment neovascularization in NVG. 2,3 Dramatic regression of iris or angle neovascularization after intracameral or ivBe injection has been reported.…”

Effect of intravitreal bevacizumab on iris vessels in neovascular glaucoma patients

“…Previous studies have reported the time-sensitive nature of bevacizumab's anti-neovascularization activities, and that iris neovascularization regresses or disappears within 1 week [22][23][24][25][26]. We took iris specimens 7±1 days after IVB injection.…”

“…Trabeculectomy with mitomycin C is an equivalent option to cyclodestructive methods or implant surgery [21]. Many previous studies reported that trabeculectomy is effective for NVG [22][23][24][25], and glaucoma implant surgery has not been approved in Japan. Therefore, we selected trabeculectomy for these cases in the study.…”

Level of Vascular Endothelial Growth Factor in Aqueous Humor and Surgical Results of Ahmed Glaucoma Valve Implantation in Patients With Neovascular Glaucoma

“…Panretinal photocoagulation (PRP) combined with trabeculectomy with mitomycin-C can effectively reduce the elevated intraocular pressure (IOP) in eyes with NVG secondary to diabetic retinopathy. 7 PRP leads to decrease the levels of proliferative factors and IOP in early NVG. TGF-b can activate the proliferation of fibroblasts and has been known to influence surgical results after trabeculectomy.…”