FEATURES OF SURGICAL TREATMENT OF NEOVASCULAR GLAUCOMA

Abstract

Neovascular glaucoma (NVG) is a severe, vision-threatening condition characterized by the development of new abnormal blood vessels in the anterior segment of the eye, most commonly as a complication of ischemic retinal diseases. These fragile neovessels can obstruct aqueous humor outflow, resulting in dangerously elevated intraocular pressure (IOP) and irreversible vision loss. The surgical management of NVG is highly complex due to the disease’s aggressive progression and the underlying retinal pathology. While medical therapy and laser treatments play a critical role in early disease stages, most patients eventually require surgical intervention to control IOP and preserve the remaining vision.

This article aims to explore in detail the pathogenesis, clinical features, and especially the surgical treatment strategies for NVG. It reviews traditional and modern surgical techniques, including trabeculectomy, glaucoma drainage implants (GDIs), cyclodestructive procedures, and their combinations with anti-VEGF therapy and panretinal photocoagulation. The choice of surgical approach depends on disease stage, visual potential, and ocular status. Furthermore, the integration of pharmacologic agents like anti-VEGF medications has revolutionized preoperative and perioperative care, improving surgical outcomes and reducing complications. By examining these developments, this review highlights the need for an individualized, stepwise treatment strategy to improve patient outcomes in NVG.