Combined surgery for neovascular glaucoma

Objective To evaluate the therapeutic effects of combined surgery for neovaecular glaucoma.Meth- ods 21 eyes d neovascular glaucoma were treated by combined surgery:trabeculectomy with MMC(0.2mg/ml,5min), amniotic membrane transplantation (subscleral flap and subconjunctival flap),plus panretinal cryotherapy.Intraocular pressure(IOP),filtering bleb were observed during the fellow period (6～12 months).Results IOP of this consecutive patients was reduced from 36～76mmHg(means 48.9mmHg) to 7～18 mmHg(mesns12.5 mmHg) in 31 eyes,10～29 mmHg(means 13.5 mmHg) in 31 eyes,10～31 mmHg(means 17.5 mmHg) in 28 eyes,11～31mmHg(means 17 mmHg) in 24 eyes at postoperation 5～7 days,3,6 and 12 months respectively.IOP≤21mmHg in 25 eyes without medicine and in 4 eyes with topical medicine at postoperation 3 months,IOP≤21mmHg in 19 eyes without medicine and in 5 eyes with top- ical medicine st postoperation 6 months.IOP≤21mmHg in 12 eyes without medicine and in 7 eyes with topical medicine at postoperation 12 months.The operative success rate were 93.5%,85.7%,79.1% at postoperation 3,6 and 12 months respectively.The functional and non-functional feltering bleb were seen in 14 and 14 eyes,11 and 13 eyes,at postopera- tion 6 and 12 months respectively.The neovascular of 24 and 18 eyes disappeared at poetoperation 6 and 12 months re- spectively.Operative complications included:hyphema 11 eyes,exudation 3 eyes,choroid detachment 6 eyes,malignant glaucoma 1 eyes.Conclusion It is effective and safe to treate neovascular glaucoma by combined surgery:trabeculectomy with MMC,amniotic membrane transplantation plus panretinal cryotherapy.