Pars plana filtration with multiple laser perforation of the uvea for neovascular glaucoma following proliferative diabetic retinopathy

Purpose: To evaluate the effect of pars plana filtration with multiple lase r perforation of the uvea in neovascular glaucoma patients following prolif erative diabetic retinopathy. Methods: In 18 eyes of 13 patients, after a fornix-based conjunctival incis ion, two 9 X 3 mm, thin, rectangular scleral flaps were created 3-6 mm post erior to the limbus. The remaining layers of sclera under each nap were rem oved. The exposed uvea was irradiated at a mean of 60.6 spots with an argon laser just to the point of perforation. After the posterior chamber fluid escaped, the naps were sutured. Results: The mean preoperative intraocular pressure (IOP) was 36.4 +/- 9.0 mm Hg. After an average follow-up of 16.6 +/- 5.9 months, the mean final po stoperative IOP was 16.6 +/- 4.4 mm Hg. The postoperative IOP was below 21 rum Hg in 3 (16.7%) of the 18 eyes without medication. in 14 (77.8%) on ant i-glaucoma eye drops, and in 16 (88.9%) on anti-glaucoma eye drops and an o ral carbonic anhydrase inhibitor. Snellen visual acuity improved by more th an 2 lines in 7 of the 18 eyes, worsened by this amount in 3, and remained within baseline +/- 2 lines in 8. Conclusion: This procedure is an effective treatment for neovascular glauco ma patients following proliferative diabetic retinopathy. (C) 2000 Japanese Ophthalmological Society.