Abstract
Purpose :
Neovascular glaucoma (NVG) is considered refractory glaucoma, but visual outcomes after glaucoma surgery may vary due to the unique etiology and sudden increase in intraocular pressure (IOP). This study investigated the factors related to surgical outcomes, including visual acuity (VA) improvement after glaucoma surgery in eyes with NVG.
Methods :
This was a retrospective observational study, and 116 eyes of 116 patients with NVG who underwent trabeculectomy (TLE) or Ahmed glaucoma valve (AGV) implantation performed by a single surgeon in Ulsan national university were included. Complete surgical success at 6 months was defined as improved VA and sufficient IOP reduction (IOP ≤21 mmHg, ≥20% IOP reduction, regardless of medications) without additional glaucoma surgery and progression to NLP or hypotony (IOP ≤5 mmHg at last 2 consecutive visits). Qualified surgical success at 6 months was defined as complete success, excluding improved VA. Preoperative characteristics were investigated, including best-corrected VA (BCVA), IOP, medications, angle status, and underlying retinal etiologies. Postoperative outcomes were measured up to 6 months to avoid visual deterioration caused by the progression of underlying retinal diseases.
Results :
Complete surgical success rate was 44.6 %, and the qualified surgical success rate was 92.2 % at 6 months. Comparison between complete and without complete surgical success showed that younger age (p < 0.001), better preoperative BCVA (p = 0.028), a shorter period of decreased VA before surgery (p = 0.014), closed angle status (p = 0.017), underlying etiology in favor of proliferative diabetic retinopathy (p = 0.042), and better postoperative BCVA at 1 month (p < 0.001) were associated with complete surgical success.
Conclusions :
Patients with NVG who had younger age, proliferative diabetic retinopathy as an underlying etiology, and complete angle closure had a greater chance of sufficient IOP reduction and improved VA after glaucoma surgery.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.