Trabeculectomy with mitomycin C for treatment of neovascular glaucoma in diabetic patients.
BACKGROUND
To assess the efficacy and to determine the risk factors of trabeculectomy with mitomycin C (MMC) in eyes with neovascular glaucoma (NVG) secondary to diabetic retinopathy.


METHODS
Kaplan-Meier survival analysis of the surgical outcome was performed on 35 eyes with NVG. Age, extent of peripheral anterior synechia, surgical history (cataract, glaucoma, vitrectomy), and concurrent retinal cryotherapy were evaluated to determine factors influencing the surgical outcome. The main criterion for success was a postoperative intraocular pressure (IOP) of < or = 21 mm Hg.


RESULTS
The cumulative probability of success was 67.0% at 1 year and 61.8% after 2 to 3 years. The surgical outcome was significantly better in patients without a previous vitrectomy (p = 0.03). Extensive preoperative peripheral anterior synechia was also a risk factor for surgical failure (p = 0.013).


CONCLUSIONS
Trabeculectomy with MMC can effectively reduce the elevated IOP associated with NVG. The extent of peripheral anterior synechia and a history of vitrectomy are significant negative predictors of surgical outcome.
Kiuchi
Yoshiaki
Y
Department of Ophthalmology, Otemae Hospital, Osaka, Japan. ykiuchi@otemae.gr.jp
Sugimoto
Reiko
R
Nakae
Kazuto
K
Saito
Yoshihiro
Y
Ito
Shigeo
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D017679:Cryotherapy; D003930:Diabetic Retinopathy / Q000150:complications* / Q000601:surgery; D005260:Female; D015355:Glaucoma, Neovascular / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D012307:Risk Factors; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy
D016685:Mitomycin