Neovascular glaucoma following Nd:YAG laser capsulotomy in a patient with diabetes and syphilitic uveitis

Abstract

A diabetic woman had been suffering from progressively blurry vision in the right eye for 1 year after cataract surgery. Slit lamp examination revealed bilateral band keratopathy with quiescent anteriorchamber reaction, an intumescent cataract in the left eye, and dense posterior capsular opacity in the right eye. Capsulotomy was performed, but this led to neovascular glaucoma. Because of a refractory elevation in intraocular pressure, trabeculectomy with mitomycin C treatment, vitrectomy with panretinal photocoagulation, and intravitreal injection of bevacizumab were performed. A positive rapid plasma reagin test and a positive Treponema pallidum hemagglutination assay led to the impression of syphilitic uveitis, and the patient was treated with intravenous penicillin for 2 weeks. The visual acuity of the right eye was 0.1 at the 12th-month follow up. This case shows that neovascular glaucoma may present as a complication of capsulotomy in uveitic/diabetic eyes.

Neovascular glaucoma following Nd:YAG laser capsulotomy: a rare complication in a postvitrectomised patient with diabetes

“…Pars plana vitrectomy for PDR is associated with postoperative NVG in 4%–12% of patients 6. NVG postcapsulotomy in eyes with pre-existing ocular inflammatory has also been reported 7. Multiple risk factors have been attributed to the development of NVG after vitrectomy in eyes with PDR like advanced age, high glycosylated haemoglobin and fasting blood sugars, compromised renal status and ocular risk factors like preoperative elevated IOP, iris and angle neovascularisation, and the retinal tamponade used 8…”

The use of pan-retinal photocoagulation to treat recurrent vitreous haemorrhage with neovascularisation in the context of Epstein syndrome: an MYH9-related disorder

“…In all of these scenarios the use of PRP appears effective in suppressing proangiogenic drive and facilitating the prevention of the complications of aberrant vessel formation21–24 a principle that allowed for effective treatment in this case of Epstein’s syndrome with repeated vitreous haemorrhage.…”