AIM: To observe the clinical efficacy of different treatment modalities and the influence on the levels of pigment epithelium-derived factor(PEDF)and vascular endothelial growth factor(VEGF)in patients with neovascular glaucoma(NVG)in high altitude area.

METHODS: Ninety cases of patients(90 eyes)with NVG treated in our hospital were selected as the study objects, and they were divided into Group A and Group B according to different surgery methods, 45 cases in each groups. Group A was given Ex-press glaucoma drainage device implantation, and Group B was given trabeculectomy combined with cyclocryotherapy. We observed the clinical efficacy, intraocular pressure and visual acuity in the two groups, detected the PEDF and VEGF levels in the aqueous humor, and recorded the postoperative complications.

RESULTS: The total effective rate of Group A was 91%, significantly higher than that of Group B 76%(P<0.05). At 2wk, 2 and 4mo after surgery, IOP levels were significantly lower than that before surgery(P<0.05), and those in Group A were significantly lower than those in Group B(P<0.05). There was no significantly difference in IOP levels at 6mo after surgery between the two groups(P>0.05). At 1wk after operation, the incidence of visual reduction in Group A was 7%, significantly lower than that in Group B 22%(P<0.05). At 1wk after operation, PEDF levels were significantly higher than those before operation in the two groups(P<0.05), and that in Group A was significantly higher than that in Group B(P<0.05); VEGF levels were significantly lower than that before operation in the two groups(P<0.05), and that in Group A was significantly lower than that in Group B(P<0.05). The incidence rate of complications in Group A was 4%, significantly lower than that of 18% in Group B at 6mo postoperatively(P<0.05).

CONCLUSION: Ex-press glaucoma drainage device implantation, trabeculectomy combined with cyclocryotherapy can both be used to treat patients with NVG in high altitude area. But the former can effectively maintain visual acuity, and improve PEDF and VEGF levels in aqueous humor, with fewer complications and more accurate curative effect.