Abstract:AIM: To investigate the effect of conbercept intravitreal injection combined with glaucoma drainage device implantation and panretinal photocoagulation for neovascular glaucoma(NVG)with and without vitreous hemorrhage.
METHODS: In this retrospective study, 39 eyes in 37 patients who were diagnosed with NVG with and without vitreous hemorrhage(where iridotrabecular contact is more than 180°)in the ophthalmology department of Xi'an No.1 Hospital between January 2016 and December 2017 were enrolled in this study. Patients were divided into two groups, based on whether they had vitreous hemorrhage. All patients received 0.5 mg(0.05 mL)conbercept intravitreal injection. Twenty-one eyes in 20 patiants(Group 1)without vitreous hemorrhage received EX-PRESS(P50)glaucoma drainage device implantation on 4d after conbercept intravitreal injection and then received panretinal photocoagulation 2wk after implantation. Eighteen eyes in 17 patients(Group 2)with vitreous hemorrhage received vitrectomy combined with the EX-PRESS(P50)glaucoma drainage device implantation and panretinal photocoagulation on 4d after conbercept intravitreal injection. Air or silicone oil was selectively filled according to the situation during the operation. All patients were followed up for 6mo after operation.
RESULTS: No statistical difference was found between preoperative best corrected visual acuity(BCVA)and postoperative(6mo)BCVA in Group 1(P>0.05). There was statistical difference between preoperative BCVA and postoperative(6mo)BCVA in Group 2(P<0.05). The intraocular pressure( IOP)of Group 1 at postoperative 1d, 1wk, 1, 3 and 6mo was 20.5±4.3 mmHg, 19.6±3.8 mmHg, 20.1±3.7 mmHg, 19.9±4.2 mmHg, and 19.3±2.9 mmHg, respectively. The postoperative IOP of Group 2 was 22.3±3.7 mmHg, 20.6±2.8 mmHg, 20.4±3.8 mmHg, 18.9±4.1 mmHg, and 19.3±3.4 mmHg, respectively. The postoperative IOP of every time point was significantly lower than the preoperative IOP in Group 1 and Group 2(P<0.05). During the follow up, three eyes in three patients showed a recurrence of iris neovascularization and were given one more 0.05 mL conbercept intravitreal injection.
CONCLUSION: Conbercept intravitreal injection combined with glaucoma drainage device implantation and panretinal photocoagulation can effectively reduce IOP in NVG(where the iridotrabecular touch is more than 180°).