[Surgical treatment of neovascular glaucoma].
OBJECTIVE
The neovascular glaucoma is one of the leading causes for an enucleation. The cyclocryocoagulation, the peripheral retinal cryocoagulation and the intravitreal injection of bevacizumab as combined therapy aim at the reduction of the intraocular pressure and of neovascularisation.


METHODS
This study follows up 135 patients with neovascular glaucoma who underwent the above-mentioned combined therapy consisting of cyclocryocoagulation, peripheral retinal cryocoagulation and intravitreal injection of bevacizumab.


RESULTS
The most common causes of neovascular glaucoma in our study are diabetic retinopathy and central retinal vein occlusion. The intraocular pressure was 37.4 mmHg (± 15.8) mmHg preoperatively under maximum antiglaucomatous therapy and was reduced to 19.0 (± 8.5) mmHg direct postoperatively. In the long-term intraocular pressure remained within the normal range in 93.33 % of patients. A successful reduction of the local antiglaucomatous drops of 1.9 substances to 1.7 substances was observed after 3 months. The oral intake of acetazolamide was also statistically significantly reduced. 47.37 % of the patients were normotensive without local therapy and only 3 patients were still on acetazolamide even after 1 year. The most serious complication was a phthisis bulbi in 1.5 % of patients. Overall 98.5 % of patients remained free of pain and maintained visual acuity after the end of the follow-up.


CONCLUSIONS
Long-term pressure regulation and freedom from pain were successfully achieved. For decompensated neovascular glaucoma with poor vision and painful bulb, the combination of retinal cryocoagulation and intravitreal application of bevacizumab is an important therapeutic option.
Klinik für Augenheilkunde, St.-Johannes-Hospital, Dortmund.
S
S
Fili
Klinik für Augenheilkunde, St.-Johannes-Hospital, Dortmund.
M
M
Kohlhaas
Klinik für Augenheilkunde, St.-Johannes-Hospital, Dortmund.
H
H
Schilling
Fakultät Statistik, Technische Universität Dortmund.
U
U
Ligges
Fakultät Statistik, Technische Universität Dortmund.
I
I
Zelo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D003131:Combined Modality Therapy / Q000379:methods; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D015355:Glaucoma, Neovascular / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab