Results of Combined Baerveldt Glaucoma Implant, Pars Plana Vitrectomy, and Endolaser in the Management of Advanced Neovascular Glaucoma

Abstract

Abstract: : Purpose: To present the results of combined Baerveldt glaucoma implant (BGI), pars plana vitrectomy (PPV) and endolaser (EL) in the management of patients with advanced neovascular glaucoma (NVG). Methods: Retrospective chart review of patients with advanced neovascular glaucoma who underwent BGI, PPV, and EL by two surgeons (CT and US) at the Glaucoma Associates of New York from 1999 to 2002 was performed. Results: Eleven eyes of 10 patients with advanced neovascular glaucoma were enrolled. Mean age was 65.18 years old (range 37-84). Average follow-up period was 9 months (range 2-35). 54.5% of patients had central retinal vein occlusion, and 46.5% had diabetic retinopathy. Mean intraocular pressure (IOP) before surgery was 40.54 mmHg (range 18-68), and after surgery was 12.09 mmHg (range 2-24) with an average drop of 70.17% (range 29.2-88.9%). Mean number of ocular hypotensive medications was 3.91 (range 3-5) before surgery and 1.1 (range 0-4) after surgery with a mean reduction of 72.1% (range 33-100%). Visual acuity was improved in 4 eyes by at least one line (snellen chart), and decrease in 3 eyes by one line. 1 eye had persistent Hyphema, 2 had vitreous hemorrhage, 1 had over filtration and hypotony, and 3 eyes were revised after failure. Conclusions: Combined BGI, PG, PPV, and EL appears to be an effective surgical alternative to manage advanced neovascular glaucoma.

Keywords: intraocular pressure • neovascularization • vitreoretinal surgery