Panretinal cryocoagulation or photocoagulation combined with trabeculectomy for neovascular glaucoma

Abstract

Objective To explore the treatment strategy for neovascular glaucoma.Methods The medical records of 28 eyes of 28 cases with neovascular glaucoma were analysed.Panretinal cryocoagulation or photocoagulation was chosen based on the degree of opacity of ocular media.Then the patients underwent trabeculectomy.The intraocular pressure,visual acuity,regression of iris neovascularization and complications were observed.Results The average follow up was 5.8 ± 2.4 months (range 3 ～ 24 months).There were 16 cases treated by panretinal cryocoagulation combined with trabeculectomy (group A).Of those 16 cases,12 cases had normal intraocular pressure after treatment.The success rate was 75.0％.The visual acuities were improved in 4 cases.Complete regression of iris neovascularization had been noted in all cases in group A.One case had explosive choroidal hemorrhage during the operation.Two cases are complicated with proliferative vitreoretinopathy which later caused retinal detachment.There were 12 cases treated by panretinal photocoagulation combined with trabeculectomy (group B).In this group,8 cases obtained controlled intraocular pressure and the success rate was 66.7％.8 cases had better visual acuities.Complete regression of iris neovascularization had been noted in 7 cases in group B.No severe complications were observed in this group.Conclusion Panretinal cryocoagulation or photocoagulation combined with trabeculectomy is an easy and reliable method in the management of neovascular glaucoma which will be popular in rural hospitals. Key words: Glauocma, neovascular; Cryocoagulation, panretinal; Photocoagulation, panretinal; Trabeculectomy; Mitomycin C