Clinical observation on intravitreal anti-VEGF injection combined with trabeculectomy for neovascular glaucoma

Abstract

Objective To evaluate the efficacy of intravitreal anti-VEGF injection combined with trabeculectomy in the treatment of neovascular glaucoma. Methods The data of 31 eyes of 30 patients with neovascular glaucoma from Oct. 2015 to May 2017 were analyzed retrospectively. All cases underwent intravitreal anti-VEGF(Conbercept or Lucentis) injection combined with trabeculectomy. Trabeculectomy was performed at 1 week after injection and the follow-up time was 6 months after surgery. Results The post-operative visual acuity(VA) were all significantly increased at 1 week, 1 and 6 months compared with those before surgery (P<0.05). The average intraocular pressure at 1 week, 1 and 6 months were(16.3±1.7)mmHg, (18.2±1.9)mmHg and (18.4±1.6)mmHg (1 mmHg=0.133 kPa) respectively. The difference were statistically significant between before and after surgery (P<0.01). At 1 week after surgery all cases had functional filter bleb. At 6 months after surgery, the functional and non-functional filtering blebs occurred in 25 eyes(80.65%) and 6 eyes(19.35%) respectively. Iris neovascularization and intraocular pressure elevation were found in 1 eye (3.23%)because of poor glycemic control. The IOP returned to normal after intravitreal anti-VEGF injection combined with filter bleb separation. The mainly postoperative complications were hyphema, shallow anterior chamber, anterior uveitis and vitreous hemorrhage. Conclusion Intravitreal anti-VEGF injection combined with trabeculectomy in treatment of neovascular glaucoma is effective. Key words: Glaucoma, neovascular; Injection, intravitreal; Anti-VEGF; Trabeculectomy