Outcomes of combination treatments in refractory neovascular glaucoma. A retrospective review in patients with advanced proliferative diabetic retinopathy

摘要

Retrospective, interventional, consecutive case series of 17 eyes with refractory neovascular glaucoma (NVG) secondary to uncontrolled proliferative diabetic retinopathy (PDR). Patients with a minimum follow up of six months were included and divided into two treatment subgroups: patients in group I went under medical treatment, panretinophotocoagulation (PRP) with or without bevacizumab and patients in group II were managed by PRP, bevacizumab and Ahmed valve.Group I included 10 eyes and group II included 7 eyes. There were no differences in age, sex or initial IOP. The mean reduction in IOP for group I was 14.8 mmHg and 30 mmHg for group II, with an interval between 10 and 47 mmHg. At six months 80% of the eyes in group I and only 43% in group II (p<0.05) needed concomitant hypotensive treatment.The implantation of Ahmed device provides an effective reduction of IOP; however, further studies with a longer follow up are necessary to evaluate long-term efficacy.