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

Abstract

Purpose: 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. Methods: 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-months, 6-months, and 12-months after operation. Results: 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-months (P ​= ​0.001), 6-months (P ​= ​0.004), and 12-months (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. Conclusions: 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-months follow-up period.

Keywords

• Neovascular glaucoma
• Endoscopic cyclophotocoagulation
• Pars plana vitrectomy
• Pan-retinal photocoagulation
• Anti-VEGF