Posters

Risk factors for neovascular glaucoma after vitrectomy in patients with complicated proliferative diabetic retinopathy

Poster Details

First Author: A.Ben Youssef TUNISIA

Co Author(s):    H. Zgolli   O. Fekih   S. Mabrouk   I. Zghal   L. Nacef        

Abstract Details

Purpose:

The development of neovascular glaucoma (NVG) is a major complication that may occur following a pars-plana vitrectomy (PPV) in eyes with proliferative diabetic retinopathy (PDR). Its incidence is estimated to be between 2 and 18%. Our purpose was to determine the potential risk factors that would promote the development of NVG after vitrectomy.

Setting:

Hédi Rais institute of Ophthalmology, Department "A". Tunis, Tunisia.

Methods:

We conducted a descriptive and analytical retrospective study that included patients who underwent PPV for complications of PDR and followed up for a 12-month period. Data collection was based on patients' medical records and surgical reports. Examined parameters were age, sex, type of treatment for diabetes, fasting glucose levels, preoperative best-corrected visual acuity, preoperative intra-ocular pressure (IOP), iris neovascularization, lens status, intra-retinal tamponade use, preoperative panretinal photocoagulation (PRP) and pre- or peroperative intravitreal bevacizumab injections. Excluded from the study were patients who were poorly followed and those with silicone oil left in place for more than 3 months.

Results:

Our population was on average 45 years old with a sex ratio of 1.5. Two-thirds were on insulin therapy. Iris neovascularization was found in 11% of cases and elevated IOP in 8%. Seventy-three percent of patients were phakic. PPV was performed for intravitreal hemorrhage in 70% of cases and tractional retinal detachment in 30% of cases. Prior to surgery PRP was performed in 86% of cases. Post-operative NVG was noted in 13% of cases. A significant correlation was found between the occurrence of NVG and male sex, preoperative iris neovascularization, absence of PRP, insulin therapy and preoperatively elevated IOP.

Conclusions:

The development of NVG after pars-plana vitrectomy in diabetic eyes is a severe complication. While we currently have many therapeutic means at our disposal to control it, it remains a significant source of visual impairment. Identification of the risk factors involved in its onset thus seems essential in order to establish an adequate therapeutic strategy.

Financial Disclosure:

None