Outcomes of vitrectomy, complete pan-retinal photocoagulation, and endoscopic cyclophotocoagulation surgery after anti-VEGF treatment in neovascular glaucoma

• Published in: Advances in ophthalmology practice and research 2023-08, Vol.3 (3), p.112-118
• Main Authors: Li, Jinglan, Zhang, Siwenyue, Hou, Baoke
• Format: Article
• Language: English
• Subjects: Anti-VEGF; Endoscopic cyclophotocoagulation; Full Length; Neovascular glaucoma; Pan-retinal photocoagulation; Pars plana vitrectomy
• ISSN: 2667-3762; 2667-3762
• DOI: 10.1016/j.aopr.2023.05.001

To establish a comprehensive treatment strategy and evaluate the efficacy of combination of anti-vascular endothelial growth factor (VEGF) injection, pars plana vitrectomy (PPV), endoscopic pan-retinal photocoagulation (PRP), and endoscopic cyclophotocoagulation (ECP) surgery for neovascular glaucoma (NVG) patients. This retrospective study included 30 patients (30 eyes) who were suffering from NVG and treated with PPV & PRP & ECP (ECP group, 16 eyes), or Ahmed glaucoma valve implantation (Ahmed group, 14 eyes). The intraocular pressure (IOP), number of postoperative anti-glaucoma medications, best-corrected visual acuity (BCVA), successful rate of surgery, and postoperative complications were recorded and statistically analyzed at the time points of preoperative, 1-day, 1-month, 3-month, 6-month, and 12-month after operation. An obvious reduction in IOP and number of postoperative anti-glaucoma medications were observed in both the ECP group and Ahmed group after operation (P ​ ​0.05), while it was significantly improved in ECP group at 3-month (P ​= ​0.001), 6-month (P ​= ​0.004), and 12-month (P ​= ​0.010) time points comparing with preoperative BCVA. The surgical success rates in ECP group were also slightly higher than Ahmed group. And the complications after operation showed no marked differences. The comprehensive treatment of PPV, endoscopic PRP, and ECP surgery for NVG patients after anti-VEGF injection can control IOP effectively and be friendly to patients’ BCVA without obvious serious complications throughout a 12-month follow-up period.