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Various modalities for management of secondary angle closure neovascular glaucoma in diabetic eyes: 1-year comparative study

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Abstract

Purpose

To compare outcome of 4 methods for management of angle closure neovascular glaucoma (NVG) in diabetic eyes.

Methods

Prospective comparative study, on 40 eyes (40 patients) with NVG. Patients were randomly assigned to group A (Trabeculectomy with MMC), B (Ahmed valve), C (Ex-Press Minishunt with MMC) or D (Diode cyclophotocoagulation). Patients were followed regularly for 1 year. Main outcome measures: intraocular pressure (IOP), best corrected visual acuity (BCVA), central foveal thickness (CFT), intraoperative bleeding, postoperative complications and 2ry intervention.

Results

Preoperative data were not significantly different between 4 groups. Postoperatively, there was significant drop in IOP in each group at each follow-up. Ahmed valve group showed least mean postoperative IOP and highest mean drop of the IOP at 1 day and 1 week postoperatively, while Ex-Press minishunt group had least mean postoperative IOP at 1 month and 3 months postoperatively. At 6 months and 1 year, there was no significant difference between 4 groups. BCVA was not significantly different between 4 groups. At 1 year, CFT was significantly lower in each of the 4 groups, and it was significantly the least in group A and highest in group D. Highest intraoperative bleeding was observed with trabeculectomy. Success rate was not significantly different among the 4 groups.

Conclusion

The 4 management options showed a significant long-term effect on IOP, and on long-terms there was no significant difference between them for IOP and BCVA. Trabeculectomy showed highest incidence of intraoperative bleeding, while cyclophotocoagulation showed none.

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Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

The authors have no financial or proprietary interest in any product mentioned in this paper.

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Authors and Affiliations

  1. Cairo University, Agouza, Egypt

    Heba Magdy Ahmed El-Saied & Mohamad Amr Salah Eddin Abdelhakim

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  1. Heba Magdy Ahmed El-Saied
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  2. Mohamad Amr Salah Eddin Abdelhakim
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Contributions

HMES: contributed to collection of data, conduction of study, analysis and interpretation of data and drafting the work; MASA: contributed to collection of data, conduction of study, analysis and interpretation of data and drafting the work.

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Correspondence to Heba Magdy Ahmed El-Saied.

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El-Saied, H.M.A., Abdelhakim, M.A.S.E. Various modalities for management of secondary angle closure neovascular glaucoma in diabetic eyes: 1-year comparative study. Int Ophthalmol 41, 1179–1190 (2021). https://doi.org/10.1007/s10792-020-01673-1

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  • DOI: https://doi.org/10.1007/s10792-020-01673-1

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