Clinical Challenges with Neovascular Glaucoma-Patient Tailored Strategies and Outcomes.

BACKGROUND

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. Methodology: Ninety-seven (97) eyes with NVG seen between January 2022-September 2023 at a tertiary eye care centre, 6 eyes (4 proliferative diabetic retinopathy and 2 retinal vein occlusion) that underwent concurrent retinal and glaucoma procedures with or without cataract surgery, were recruited. Outcomes after surgery were based on the World Glaucoma Association guidelines on the reporting of glaucoma surgical trials that comprise functional and surgical parameters.

RESULTS

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.

CONCLUSION

The outcomes after concurrent retinal and glaucoma filtering surgery in NVG may provide favourable outcomes comparable to the traditional stepwise approach to management provided these are offered on a case-case basis.