Triple Procedure for Dense Cataractous Neovascular Glaucoma Patients.

Area of Science:

• Ophthalmology
• Surgical Procedures
• Glaucoma Research

Background:

• Neovascular glaucoma (NVG) is a severe form of glaucoma, often challenging to treat.
• The presence of dense cataracts complicates NVG management, requiring combined surgical approaches.

Purpose of the Study:

• To evaluate the outcomes of a triple surgical procedure for patients with NVG and dense cataracts.
• To assess the safety and efficacy of this combined approach in managing complex glaucoma cases.

Main Methods:

• A case series of 12 patients with NVG and dense cataracts.
• Patients underwent intravitreal bevacizumab injection followed by phacoemulsification, pars plana vitrectomy (PPV) with panretinal photocoagulation (PRP), and trabeculectomy with mitomycin C (MMC).
• Intraocular pressure (IOP) and best corrected distant visual acuity (BCDVA) were monitored over 2 years.

Main Results:

• Significant improvement in BCDVA from a mean LogMAR of 2.13 to 1.01 at 24 months (P < 0.0001).
• Mean IOP decreased significantly from a preoperative level of 47.25 mmHg to 16.17 mmHg at 24 months (P < 0.0001).
• Complete success rate was 90.9%, qualified success was 100%, with regression of neovascularization and no serious complications.

Conclusions:

• The triple surgical procedure offers a safe and effective treatment for NVG with dense cataracts.
• This approach leads to significant improvements in both visual acuity and IOP control.
• The study is registered with NCT04143620.