March 2012
Volume 53, Issue 14
ARVO Annual Meeting Abstract  |   March 2012
Characteristics and Outcomes of Eyes with Neovascular Glaucoma (NVG) that Underwent Combined Pars Plana Vitrectomy (PPV) and Baerveldt Glaucoma Shunt Procedure
Author Affiliations & Notes
  • Christopher W. Seery
    UMDNJ/ Bucknell University, Florham Park, New Jersey
  • Christopher Seery
    UMDNJ, Newark, New Jersey
  • Parisa Emami-Naeimi
    UMDNJ, Newark, New Jersey
  • Anton Kolomeyer
    UMDNJ, Newark, New Jersey
  • Marco Zarbin
    UMDNJ, Newark, New Jersey
  • Robert Fetchner
    UMDNJ, Newark, New Jersey
  • Neelakshi Bhagat
    UMDNJ, Newark, New Jersey
  • Footnotes
    Commercial Relationships  Christopher W. Seery, None; Christopher Seery, None; Parisa Emami-Naeimi, None; Anton Kolomeyer, None; Marco Zarbin, None; Robert Fetchner, None; Neelakshi Bhagat, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 5932. doi:
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      Christopher W. Seery, Christopher Seery, Parisa Emami-Naeimi, Anton Kolomeyer, Marco Zarbin, Robert Fetchner, Neelakshi Bhagat; Characteristics and Outcomes of Eyes with Neovascular Glaucoma (NVG) that Underwent Combined Pars Plana Vitrectomy (PPV) and Baerveldt Glaucoma Shunt Procedure. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5932.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : To describe characteristics and outcomes of eyes with NVG that underwent combined PPV and Baerveldt glaucoma shunt procedure from 2005-2010.

Methods: : Retrospective series. Changes in IOP and glaucoma medications were compared by a paired sample t-test. A Kaplan-Meier survival curve was constructed to evaluate IOP control as a function of time.

Results: : Eighty-nine eyes undergoing a combined procedure for NVG were identified. Mean patient age was 69.0 years (range:37-90); 48 (53.9%) were male. The mean follow-up time was 19.9 months (range: 2-66 months). The cause of NVG in 70.8 % (63) of eyes was diabetes, 22.5% (20) was central retinal vein occlusion and other diagnoses in the remaining 6 eyes. 55 eyes (61.8%) had received pan retinal photocoagulation laser, anti-VEGF intravitreal injection or both preoperatively. 9 eyes (10.1%) had undergone a prior glaucoma procedure. Mean pre-operative IOP was 36.82 mm Hg. The mean number of glaucoma drops preoperatively was 2.92. Mean IOP post-operatively was 15.76 mmHg; mean preoperative IOP and number of glaucoma medications were significantly (p<0.004) reduced by the combined procedure. 61 (68.5%) eyes encountered a hypertensive phase (IOP>21 mmHg) within a week post-operatively; all were started on IOP lowering agents and IOP normalized in 51 eyes within 3 weeks. VA of 55 (61.8%) eyes improved or remained unchanged. eyes (86.5%)underwent stent removal at a mean duration of 4.7 weeks from surgery. 4 (4.5%) eyes underwent subsequent valve revisions. Post-operative complications noted were retinal detachment in 4 (4.5%) eyes, serous choroidals in 12 (13.5 %) eyes (8 had concurrent hypotony), peripheral hemorrhagic choroidals in 2 (2.2%) eyes, 20 (22.5%) eyes with hypotony (IOP < 6 mm Hg) and endophthalmitis in 1 (1.1%) eye. Hypotony was noted in 20 eyes at a mean duration of 3.6 weeks; spontaneous resolution in 15 eyes within 2 weeks. Small gauge vitrectomy was performed in 45 (50.6%) of 89 eyes.

Conclusions: : Combined PPV and Baerveldt glaucoma shunt may be a useful procedure in reducing IOP and number of glaucoma medications in eyes with NVG along with stabilizing VA in majority of these eyes.

Keywords: intraocular pressure • neovascularization 

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