AIM:To observe the changes of vision and intraocular press in patients with neovascular glaucoma after the treatment of anti-vascular endothelial growth factor(VEGF)drugs with trabeculectomy and to explore the effectiveness and safety of this combination therapy.

METHODS:Sixty patients(60 eyes)with glaucoma went to our hospital from August 2012 to August 2014 and whose follow-up periods were >6mo were divided into two groups, group A(observation group)and group B(control group), by random number method. Observation group was treated with intravitreal injection of Ranibizumab and trabeculectomy. Control group was treated with cyclocryotherapy. The changes on visual acuity, intraocular pressure(IOP), neovascularization at iris and anterior chamber angle were observed.

RESULTS:Postoperative visual acuity improved in 9 eyes in group A which was significantly more than that of group B(P<0.05)and decreased in 5 eyes in group A which was significantly less than that of group B(P<0.05). In group A, IOP after injection of ranibizumab did not decrease much, but IOP decreased significantly after trabeculectomy and kept stable. IOP of group A after treatment was 14.6±3.7mmHg which was lower than that of group B(P<0.05). IOP of group B decreased gradually after treatment, and kept stable after 1mo. IOP of group A at 1, 3 and 6mo was lower than those of group B at the same time point(P<0.05). At the final follow up of 12mo, 26 eyes(87%)were treated successfully with IOP>30mmHg in 4 eyes. But there were more patients with relieved symptoms in group A than in group B. Fourteen eyes(47%)were treated successfully in group B with IOP> 30mmHg in 13 eyes, symptoms were relieved and IOP<7mmHg in 3 cases(P=0.026). No ocular atrophied. The rate of complication in group A was 13%, which was significantly lower than that of group B(67%, P<0.05).

CONCLUSION:The anti-VEGF drugs with trabeculectomy for neovascular glaucoma can improve visual acuity, reduce IOP, and relieve symptoms with high safety.