Rao Aparna, Padhi Tapas Ranjan, Khan Sanjib M
Glaucoma Service, LV Prasad Eye Institute, Kallam Anji Reddy campus, Hyderabad, India.
Niger Med J. 2025 Jun 16;66(2):449-456. doi: 10.71480/nmj.v66i2.586. eCollection 2025 Mar-Apr.
To report the outcomes of patient-tailored concurrent combined surgery for retinal ischemia and intraocular pressure (IOP) control in neovascular glaucoma (NVG) with or without cataract.
Patients with Ninety-seven (97) eyes with NVG seen between January 2022-September 2023 at a tertiary eye care centre were recruited for this study. Six (6) eyes (4 proliferative diabetic retinopathy and 2 retinal vein occlusions) that underwent concurrent retinal and glaucoma procedures with or without cataract surgery, were selected. Outcomes after surgery were judged based on the World Glaucoma Association guidelines on reporting glaucoma surgical trials, comprising functional and surgical parameters.
The IOP reduced by>50% from baseline in all 6 eyes, with one eye developing shallow AC by overstraining and 3 eyes developing transient self-resolving hyphema. Two eyes received additional bevacizumab (n=1) or ranibizumab (n=1) injections for persistent DME at 4 and 5 months after surgery. The final IOP was reduced in all eyes at the final follow-up of 6±1.2 months, with one eye requiring 2 medications for IOP control.
The outcomes after concurrent retinal and glaucoma filtering surgery in NVG may be comparable to those of the traditional stepwise approach to management, provided these are offered on a case-by-case basis.
报告针对合并或不合并白内障的新生血管性青光眼（NVG）患者，采用个体化同步联合手术治疗视网膜缺血和控制眼压的效果。
本研究招募了2022年1月至2023年9月期间在一家三级眼科护理中心就诊的97例NVG患者的97只眼。选取了6只眼（4例增殖性糖尿病视网膜病变和2例视网膜静脉阻塞），这些眼接受了同期视网膜和青光眼手术，合并或不合并白内障手术。术后结果根据世界青光眼协会关于报告青光眼手术试验的指南进行判断，包括功能和手术参数。
所有6只眼的眼压均较基线降低>50%，1只眼因过度用力出现浅前房，3只眼出现短暂的可自行消退的前房积血。2只眼在术后4个月和5个月因持续性糖尿病性黄斑水肿接受了额外的贝伐单抗（n = 1）或雷珠单抗（n = 1）注射。在6±1.2个月的最终随访中，所有眼的最终眼压均降低，1只眼需要2种药物来控制眼压。
NVG患者同期视网膜和青光眼滤过手术后的效果可能与传统的分步治疗方法相当，前提是根据具体情况进行手术。
