Trabeculectomy With Mitomycin C Combined With Direct Cauterization of Peripheral Iris in the Management of Neovascular Glaucoma

Abstract

Trabeculectomy with MMC combined with direct cauterization of peripheral iris decreases the incidence of both intraoperative bleeding, and early postoperative hyphema, and provides reduction of IOP and the number of antiglaucomatous medications in cases with NVG in a 6-month follow-up period.

Adjunctive Intravitreal Bevacizumab-Combined Trabeculectomy Versus Trabeculectomy Alone in the Treatment of Neovascular Glaucoma

“…15 Unfortunately, trabeculectomy alone and other shunt-tube drainage procedures for NVG are challenging because neovessels tend to recur and bleed easily and are always associated with postoperative infl ammation, higher rate of failure to control the IOP, or unsatisfactory visual stabilization. [16][17][18] ivBe injection. However, NVI recurred and IOP rose to 34-38 mm Hg range after the 5-week period, re-injection was performed and followed trabeculectomy.…”

Effect of intravitreal bevacizumab on iris vessels in neovascular glaucoma patients

“…Previous studies have reported the time-sensitive nature of bevacizumab's anti-neovascularization activities, and that iris neovascularization regresses or disappears within 1 week [22][23][24][25][26]. We took iris specimens 7±1 days after IVB injection.…”

“…Trabeculectomy with mitomycin C is an equivalent option to cyclodestructive methods or implant surgery [21]. Many previous studies reported that trabeculectomy is effective for NVG [22][23][24][25], and glaucoma implant surgery has not been approved in Japan. Therefore, we selected trabeculectomy for these cases in the study.…”

A Surgical Technique for Difficult Glaucoma Cases: Combined Cyclectomy/Trabeculectomy

“…The most common complication seen in the C/T group was hyphema. In a study reporting results after Trabeculectomy with MMC combined with direct cauterization of peripheral iris in patients with NVG, 20.8% hyphema was reported, in which irrigation of the anterior chamber was required for three eyes (Elgin et al, 2006). We had a rate of 40% but all the hyphemas were resolved spontaneously in our series.…”