J Korean Ophthalmol Soc.  2021 Jul;62(7):963-968. 10.3341/jkos.2021.62.7.963.

Neovascular Glaucoma after Diabetic Vitrectomy: Incidence and Risk Factors

• Son HW
• Park JM
• Yeom MI

• KMID: 2518499
• DOI: http://doi.org/10.3341/jkos.2021.62.7.963

Abstract

Purpose
The prevalence and risk factors of neovascular glaucoma (NVG) after diabetic vitrectomy were evaluated.
Methods
This retrospective study included 171 eyes of 141 patients who underwent diabetic vitrectomy in-hospital between March 2013 and July 2019 and were followed for >12 months postoperatively. Regardless of the presence or absence of neovascularization in the anterior segment, all patients received injections of intravitreal bevacizumab during vitrectomy. Patients with preoperative neovascularization in iris (NVI) or angle (NVA) received both intracameral and intravitreal bevacizumab injections. Data were collected regarding baseline demographics, preoperative best-corrected visual acuity, intraocular pressure, hypertension, NVG in the fellow eye, panretinal photocoagulation history, iris and angle neovascularization, and postoperative findings (e.g., rebleeding and residual retinal detachment).
Results
In total, 141 patients and 171 eyes were included in the study, and the incidence of postoperative NVG was 5.85% (10 patients). Five patients (27.78%) with preoperative NVI or NVA developed postoperative NVG. Significant risk factors for postoperative NVG were preoperative NVA or NVI (odds ratio [OR] = 16.428, p = 0.003), shorter diabetic duration (OR = 0.853, p = 0.033), and the absence of preoperative panretinal photocoagulation (OR = 0.006, p = 0.035).
Conclusions
There is a high possibility of postoperative NVG in patients with preoperative NVI or NVA, a short duration of diabetes, and no preoperative panretinal photocoagulation. In such patients, close monitoring is required after diabetic vitrectomy.

Keyword

Complications, Diabetic retinopathy, Neovascular glaucoma, Vitrectomy