Pegu Julie, Garg Prerna, Shakya Rakesh, Dubey Suneeta, Dash Debashish, Ahluwalia Navjot, Pandit Kushal, Kumar Mukesh, Gandhi Monica, Mazumdar Atanu
Department of Glaucoma and Anterior Segment, Glaucoma Services, Dr. Shroff's Charity Eye Hospital, New Delhi, India.
Glaucoma Services, SNC, Chitrakoot, Madhya Pradesh, India.
Indian J Ophthalmol. 2025 Mar 1;73(Suppl 2):S254-S259. doi: 10.4103/IJO.IJO_3145_23. Epub 2024 Aug 14.
This study aimed to evaluate and compare surgical outcomes among neovascular glaucoma patients undergoing trabeculectomy (Trab), glaucoma drainage device (GDD) implantation, or trans-scleral cyclophotocoagulation (TSCPC).
This study analyzed the records of 176 neovascular glaucoma cases treated surgically between January 2017 and December 2021 at four Indian centers. Procedures included trabeculectomy with MMC in 80 eyes, GDD implantation in 25 eyes, and TSCPC in 71 eyes. Outcome measures comprised intraocular pressure (IOP) reduction, antiglaucoma medication (AGM) usage, complications, and best-corrected visual acuity (BCVA).
Following surgery, all groups exhibited a significant reduction in IOP. One year postoperatively, complete success rates were 42.9% for the implant group, 54.3% for the Trab group, and 33.3% for the TSCPC group, with corresponding qualified success rates of 57.1%, 36.7%, and 58.9%, respectively. Improvement in postoperative vision was noted, with an increase of 0.24 LogMAR in the Trab group, 0.11 in the GDD group, and a decrease of 0.35 in the TSCPC group. Complications occurred in 27% of Trab and 14% of TSCPC cases, while the GDD group experienced a hypertensive phase in 40% of eyes.
In managing neovascular glaucoma, trabeculectomy, GDD, and TSCPC provide comparable IOP control, with GDD showing a higher medication dependency. Trabeculectomy yields superior vision outcomes but carries a higher risk of postoperative complications, emphasizing the importance of individualized treatment selection and vigilant postoperative care.
本研究旨在评估和比较接受小梁切除术（Trab）、青光眼引流装置（GDD）植入术或经巩膜睫状体光凝术（TSCPC）的新生血管性青光眼患者的手术效果。
本研究分析了2017年1月至2021年12月期间在印度四个中心接受手术治疗的176例新生血管性青光眼病例的记录。手术包括80眼行含丝裂霉素C的小梁切除术、25眼行GDD植入术和71眼行TSCPC。观察指标包括眼压降低、抗青光眼药物（AGM）使用情况、并发症及最佳矫正视力（BCVA）。
术后所有组眼压均显著降低。术后1年，植入组完全成功率为42.9%，小梁切除术组为54.3%，TSCPC组为33.3%，相应的合格成功率分别为57.1%、36.7%和58.9%。术后视力有改善，小梁切除术组LogMAR增加0.24，GDD组增加0.11，TSCPC组降低0.35。小梁切除术组27%的病例和TSCPC组14%的病例发生并发症，而GDD组40%的眼出现高血压期。
在治疗新生血管性青光眼方面，小梁切除术、GDD植入术和TSCPC在眼压控制方面效果相当，GDD显示出更高的药物依赖性。小梁切除术产生更好的视力结果，但术后并发症风险更高，强调了个体化治疗选择和术后密切观察的重要性。
