Abstract:AIM: To investigate therapeutic effects of combination therapy for neovascular glaucoma(NVG).
METHODS: This retrospective study comprised 34 eyes of 34 patients who suffered from NVG. All patients were assigned to group A, B, C and D according to the different combination therapies. Group A(11 eyes of 11 patients)was treated with intravitreal injection of ranibizumab and panretinal photocoagulation(PRP). Group B(10 eyes of 10 patients)was treated with transcleral cyclophotocoagulation and PRP. Group C(6 eyes of 6 patients)was treated with 3 therapies together. Group D(7 eyes of 7 patients)was treated with 810nm transcleral cyclophotocoagulation and soft gas-permeable contact lenses. All the patients were followed-up for 1a. The best-corrected visual acuity(BCVA), intraocular pressure(IOP)were recorded and analyzed prior to operation and 1, 4wk, 6 and 12mo after operation.
RESULTS: All the post treatment IOP decreased significantly(P<0.05)from the values before therapy, and the IOP values after 4wk, 6, 12mo were not significantly different(P>0.05)in statistics. Most patients' IOP can be controlled below 23mmHg after combination therapy. The visual acuity in group A after 1,4wk, 6mo compared with those before treatment was significantly increased(P<0.05)in statistics and other groups did not significantly change before and after treatment(P>0.05). Anterior chamber bleeding occurred to 2 cases after 1wk of transcleral cyclophotocoagulation. No other ocular or systemic adverse events were found during the follow-up duration.
CONCLUSION: After the combination of intraocular injection of the anti-VEGF drugs, 810nm laser cyclophotocoagulation and PRP, most patients with NVG disease can be effectively treated, can effectively control IOP, and retain part of the visual function, significantly improve the quality of life. In the short-term, combination therapy is safe and effective for NVG, which provides us an available strategy to conquer NVG by simply programmable operation and less suffering.