A Clinical Comparative Study of the Combined Surgical Treatment of Neovascular Glaucoma

Objective:There were two difficult aspects in treatment of neovascular glaucoma.They are containment neovascularization by solving retinal hypoxia and reducing aqueous humor flow or finding another filtration channel due to obstruction of anterior chamber angle neovascularization.Two different strategies were employed to compare the two groups to see which group was more advantaged.Methods:By a randomized control trial study,41 patients(41 eyes)with neovascular glaucoma were randomly divided into two groups.Group A(20 eyes) was treated with iris and chamber angle neovascularization phtocoagulation and trabeculectomy combined with anterior retinal cryotherapy(ARC),while Group B(20 eyes)received cyclocryosurgery combined with anterior retinal cryotherapy(ARC). We observed the intraocular pressure(IOP) and conditions in the eye for a week and investigated the follow-up status of intraocular pressure and complication for a year.Results:There was a remarkable difference(t= 7.12,P0.01) in intraocular pressure.In Group A,it was significantly lower than that in Group B one week after the operation.Ophthalmalgia of group A was significantly relieved,showing significant difference(χ2=7.15,P 0.01).In the year after operation,intraocular pressure of Group A was controlled in the normal range,the effective rate accounting for 90%(18/20),while in Group B,the rate being 49%(10/21). The difference was statistically significant(t=2.73,P0.05).Iris neovascularization(INV)of two groups decreased,but Group A was better than Group B.Thus they had statistical differences(χ2=5.53,P0.05).Conclusion:Iris and chamber angle neovascularization phtocoagulation and trabeculectomy combined with anterior retinal cryotherapy(ARC)has more advantages.