ORIGINAL ARTICLE
Year : 2022 | Volume
: 9 | Issue : 1 | Page : 1--7
Management of stage IV neovascular glaucoma in proliferative diabetic retinopathy with single step pars plana vitrectomy + endolaser + trabeculectomy + mitomycin C versus 2-step approach, i.e., pan retinal photocoagulation followed by trabeculectomy + mitomycin C
Shilpi Narnaware1, Prashant Bawankule1, Dhananjay Raje2, Anju Bansal3, Richa Gupta4
1 VItreo Retinal Surgeon, Sarakshi Netralaya, Nagpur, Maharashtra, India
2 Statistician MDS Bio-Analytics Pvt Ltd, Nagpur, Maharashtra, India
3 DNB 2nd Year, Sarakshi Netralaya, Nagpur, Maharashtra, India
4 Glaucoma Specialist, Sarakshi Netralaya, Nagpur, Maharashtra, India
Correspondence Address:
Dr. Shilpi Narnaware
Sarakshi Netralaya, 19, Rajiv Nagar, Wardha Road, Nagpur - 440 025 Maharashtra
India
Purpose: To compare the success between single-step pars plana vitrectomy (PPV) + Endolaser (EL) + Trabeculectomy + mitomycin C (MMC) and 2-step approach, i.e., pan-retinal photocoagulation (PRP) followed by Trabeculectomy + MMC in cases of stage IV neovascular glaucoma (NVG) secondary to proliferative diabetic retinopathy (PDR). Methods: Prospective, interventional study including 16 eyes of 16 patients with stage 4 NVG in cases of PDR between July 2019 and December 2020. Depending on the type of surgery, patients were divided into two groups. Group I: PRP followed by Trabeculectomy + MMC (n = 8), Group II: Combined PPV + EL + Trabeculectomy + MMC (n = 8). All patients received intravitreal bevacizumab 3 days before the surgery in both groups. Success criteria were postoperative intraocular pressure (IOP) of <20 mm Hg with or without antiglaucoma medication. Results: Postoperative IOP decreased significantly in both groups, but the mean IOP after 6 months was lower in combined group (17 mm Hg) than trabeculectomy group (22.25 mm Hg; P = 0.204). Combined group required fewer anti-glaucoma medications (mean: 0.88) than trabeculectomy group (mean: 1.38). Cumulative surgical success rates for combined group and Trabeculectomy groups were 100% and 75% respectively. No significant differences in intraoperative complications were observed between the groups. Conclusion: In stage 4, NVG secondary to PDR, single step combined approach including PPV + EL + Trabeculectomy + MMC could be more effective in controlling IOP with better visual outcome than Trabeculectomy + MMC.
How to cite this article:
Narnaware S, Bawankule P, Raje D, Bansal A, Gupta R. Management of stage IV neovascular glaucoma in proliferative diabetic retinopathy with single step pars plana vitrectomy + endolaser + trabeculectomy + mitomycin C versus 2-step approach, i.e., pan retinal photocoagulation followed by trabeculectomy + mitomycin C.Egypt Retina J 2022;9:1-7
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How to cite this URL:
Narnaware S, Bawankule P, Raje D, Bansal A, Gupta R. Management of stage IV neovascular glaucoma in proliferative diabetic retinopathy with single step pars plana vitrectomy + endolaser + trabeculectomy + mitomycin C versus 2-step approach, i.e., pan retinal photocoagulation followed by trabeculectomy + mitomycin C. Egypt Retina J [serial online] 2022 [cited 2023 Jun 7 ];9:1-7
Available from: https://www.egyptretinaj.com/article.asp?issn=2347-5617;year=2022;volume=9;issue=1;spage=1;epage=7;aulast=Narnaware;type=0 |
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