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Trabeculectomy for Neovascular Glaucoma

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Neovascular Glaucoma

Part of the book series: Essentials in Ophthalmology ((ESSENTIALS))

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Abstract

Neovascular glaucoma (NVG) is a particularly aggressive form of secondary glaucoma in which the intraocular pressure (IOP) may become profoundly elevated, especially in the advanced stages of disease when the conventional aqueous outflow pathway becomes obstructed by peripheral anterior synechiae. When IOP elevation is recalcitrant to medical IOP-lowering therapy, an IOP-lowering surgery is often required. The success rate of the “gold standard” trabeculectomy procedure has traditionally been poor in the setting of NVG, hence the need for augmentation with antifibrotic agents such as mitomycin C (MMC) and 5-fluoruracil (5-FU). More recently, adjunctive antivascular endothelial growth factor (VEGF) agents have been used to regress anterior segment neovascularization, decrease intraoperative and postoperative bleeding, modulate postoperative fibrosis, and reduce bleb vascularity. When combined with anti-VEGF agents, the augmented trabeculectomy with antifibrotic agents remains a viable option for lowering IOP in NVG alongside other IOP-lowering surgeries such as aqueous shunts and cyclophotocoagulation.

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  1. West Virginia University Eye Institute, Morgantown, WV, USA

    Kevin M. Halenda

  2. Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA

    Annapurna Singh

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Correspondence to Annapurna Singh .

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  1. Ophthalmology and Visual Science, University of Chicago, Chicago, IL, USA

    Mary Qiu

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Halenda, K.M., Singh, A. (2022). Trabeculectomy for Neovascular Glaucoma. In: Qiu, M. (eds) Neovascular Glaucoma. Essentials in Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-031-11720-6_16

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