Clinical Challenges with Neovascular Glaucoma-Patient Tailored Strategies and Outcomes

Area of Science:

• Ophthalmology
• Surgical Innovation
• Glaucoma Research

Background:

• Neovascular glaucoma (NVG) presents complex challenges requiring integrated management strategies.
• Retinal ischemia and elevated intraocular pressure (IOP) often coexist in NVG, necessitating combined treatment approaches.
• Traditional management involves stepwise interventions, which may not always be optimal for complex cases.

Purpose of the Study:

• To evaluate the outcomes of patient-tailored concurrent combined surgery for NVG.
• To assess the efficacy of combined retinal and glaucoma procedures in controlling IOP and managing retinal ischemia.
• To compare the results with traditional management protocols.

Main Methods:

• A retrospective analysis of 6 eyes with NVG undergoing concurrent retinal and glaucoma procedures between January 2022 and September 2023.
• Procedures included combined retinal and glaucoma surgery, with or without cataract extraction.
• Outcomes were assessed based on World Glaucoma Association guidelines, including functional and surgical parameters.

Main Results:

• All 6 eyes achieved a >50% reduction in IOP from baseline.
• One eye experienced shallow anterior chamber (AC), and three had transient hyphema, all self-resolving.
• Final IOP was reduced at 6±1.2 months follow-up, with one eye requiring two medications for control.

Conclusions:

• Concurrent combined surgery offers favorable outcomes for NVG management, comparable to stepwise approaches.
• This approach may be a viable alternative for selected NVG patients.
• Individualized, case-by-case application is recommended for optimal results.