Pars plana filtration with multiple laser perforation of the uvea for neovascular glaucoma following proliferative diabetic retinopathy.
OBJECTIVE
To evaluate the effect of pars plana filtration with multiple laser perforation of the uvea in neovascular glaucoma patients following proliferative diabetic retinopathy.


METHODS
In 18 eyes of 13 patients, after a fornix-based conjunctival incision, two 9 x 3 mm, thin, rectangular scleral flaps were created 3-6 mm posterior to the limbus. The remaining layers of sclera under each flap were removed. The exposed uvea was irradiated at a mean of 60.6 spots with an argon laser just to the point of perforation. After the posterior chamber fluid escaped, the flaps were sutured.


RESULTS
The mean preoperative intraocular pressure (IOP) was 36.4 +/- 9.0 mm Hg. After an average follow-up of 16.6 +/- 5.9 months, the mean final postoperative IOP was 16.6 +/- 4.4 mm Hg. The postoperative IOP was below 21 mm Hg in 3 (16.7%) of the 18 eyes without medication, in 14 (77.8%) on anti-glaucoma eye drops, and in 16 (88. 9%) on anti-glaucoma eye drops and an oral carbonic anhydrase inhibitor. Snellen visual acuity improved by more than 2 lines in 7 of the 18 eyes, worsened by this amount in 3, and remained within baseline +/- 2 lines in 8.


CONCLUSIONS
This procedure is an effective treatment for neovascular glaucoma patients following proliferative diabetic retinopathy.
Mabuchi
F
F
Kurihara Eye Hospital, Saitama, Japan.
Kurihara
H
H
Ogino
N
N
Tsukahara
S
S
D000086:Acetazolamide / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000477:Alkylating Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use; D003930:Diabetic Retinopathy / Q000150:complications*; D004359:Drug Therapy, Combination; D005260:Female; D018463:Filtering Surgery / Q000379:methods*; D015355:Glaucoma, Neovascular / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use; D012590:Sclera / Q000601:surgery; D013524:Surgical Flaps; D014602:Uvea / Q000601:surgery*; D014792:Visual Acuity
D000477:Alkylating Agents; D000959:Antihypertensive Agents; D002257:Carbonic Anhydrase Inhibitors; D016685:Mitomycin; D000086:Acetazolamide