Treatment of diabetic neovascular glaucoma by panretinal ablation and trabeculectomy

The efficacy of treating diabetic neovascular glaucoma by panretinal cryotherapy and trabeculectomy was studied over post-operative periods of 6-24 months in 26 selected eyes (8 acute cases and 18 chronic cases). The only complications attributable to surgery were slight hyphemas. Mean pre-operative intraocular pressure (IOP) among the acute cases was 48.8 +/- 9.9 mmHg. After 1 year, IOP was under control (IOP less than or equal to 22 mmHg) in 6 eyes (75%) (2 patients needed hypotensive drugs and another required surgery again). Among the chronic cases, pre-operative IOP was 30.1 +/- 2.1, while a year after surgery IOP was under control (IOP less than or equal to 22 mmHg) in 14 patients (77%) (5 of these needed hypotensive medication and 2 a second operation). The visual acuity (VA) of 66% of the chronic cases was unaltered a year after surgery. The VA of 63% of the acute cases was better a year after surgery. The VA of the 8 patients re-examined 2 years after surgery had deteriorated in spite of their IOP being under control.