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CLINICAL TRIAL
JOURNAL ARTICLE
[Results of trabeculectomy with anti-VGEF therapy in the treatment of neovascular glaucoma secondary to retinal vein occlusion (report of 21 cases followed at Bukavu Eye Clinic from January 1 to December 31th, 2015)].
Journal Français D'ophtalmologie 2017 January
PURPOSE: To evaluate the results of anti-VGEF with trabeculectomy in the treatment of neovascular glaucoma, a severe complication of retinal vein occlusion (RVO).
PATIENTS AND METHODS: This is a prospective case series of consecutive patients with neovascular glaucoma secondary to retinal vein occlusion. All patients underwent panretinal photocoagulation and a mean of 3 anti-VEGF injections prior to trabeculectomy. Ophthalmic parameters were recorded pre- and postoperatively: visual acuity (VA), intraocular pressure (IOP), iris examination, gonioscopy and fundus examination, and as necessary, fluorescein angiography. Minimum follow-up was 9 months.
RESULTS: Twenty-one eyes of 21 patients were included. The mean preoperative intraocular pressure was 38mmHg (31-45mmHg). Postoperatively, the mean IOP was 15mmHg (13-19mmHg). IOP reduction was observed in all eyes after surgery and stayed finally stabilized in nineteen eyes (90.5 %). The rubeosis had definitively disappeared an average of two weeks after injection, but VA decreased in all patients. Nineteen patients (90.5 %) maintained preservation of their eyes. Two eyes underwent evisceration.
CONCLUSION: In most cases, trabeculectomy with anti-VGEF halted anterior segment neovascularization. It allowed for surgery on a quiet, normotensive eye, with good postoperative results. While functional rehabilitation was not achieved, the globe was able to be preserved in 90.5 % of cases.
PATIENTS AND METHODS: This is a prospective case series of consecutive patients with neovascular glaucoma secondary to retinal vein occlusion. All patients underwent panretinal photocoagulation and a mean of 3 anti-VEGF injections prior to trabeculectomy. Ophthalmic parameters were recorded pre- and postoperatively: visual acuity (VA), intraocular pressure (IOP), iris examination, gonioscopy and fundus examination, and as necessary, fluorescein angiography. Minimum follow-up was 9 months.
RESULTS: Twenty-one eyes of 21 patients were included. The mean preoperative intraocular pressure was 38mmHg (31-45mmHg). Postoperatively, the mean IOP was 15mmHg (13-19mmHg). IOP reduction was observed in all eyes after surgery and stayed finally stabilized in nineteen eyes (90.5 %). The rubeosis had definitively disappeared an average of two weeks after injection, but VA decreased in all patients. Nineteen patients (90.5 %) maintained preservation of their eyes. Two eyes underwent evisceration.
CONCLUSION: In most cases, trabeculectomy with anti-VGEF halted anterior segment neovascularization. It allowed for surgery on a quiet, normotensive eye, with good postoperative results. While functional rehabilitation was not achieved, the globe was able to be preserved in 90.5 % of cases.
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