Background: To assess the efficacy and to determine the risk factors of trabeculectomy with mitomycin C (MMC) in eyes with neovascular glaucoma (NVG) secondary to diabetic retinopathy. Methods: Kaplan-Meier survival analysis of the surgical outcome was performed on 35 eyes with NVG. Age, extent of peripheral anterior synechia, surgical history (cataract, glaucoma, vitrectomy), and concurrent retinal cryotherapy were evaluated to determine factors influencing the surgical outcome. The main criterion for success was a postoperative intraocular pressure (IOP) of ≤21 mm Hg. Results: The cumulative probability of success was 67.0% at 1 year and 61.8% after 2 to 3 years. The surgical outcome was significantly better in patients without a previous vitrectomy (p = 0.03). Extensive preoperative peripheral anterior synechia was also a risk factor for surgical failure (p = 0.013). Conclusions: Trabeculectomy with MMC can effectively reduce the elevated IOP associated with NVG. The extent of peripheral anterior synechia and a history of vitrectomy are significant negative predictors of surgical outcome.

Gartner S, Henkind P: Neovascularization of the iris (rubeosis iridis). Surv Ophthalmol 1978;22:291–312.
Brown GC, Magargal LE, Schachat A, Shah H: Neovascular glaucoma etiologic considerations. Ophthalmology 1984;91:315–320.
Sivak-Callcott JA, O’Day DM, Gass JD, Tsai JC: Evidence-based recommendations for the diagnosis and treatment of neovascular glaucoma. Ophthalmology 2001;108:1767–1776.
Rockwood EJ, Parrish RK 2nd, Heuer DK, Skuta GL, Hodapp E, Palmberg PF, Gressel MG, Feuer W: Glaucoma filtering surgery with 5-fluorouracil. Ophthalmology 1987;94:1071–1078.
Kitazawa Y, Kawase K, Matsushita H, Minobe M: Trabeculectomy with mitomycin. A comparative study with fluorouracil. Arch Ophthalmol 1991;109:1963–1998.
The Fluorouracil Filtering Surgery Study Group: Three-year follow-up of the fluorouracil filtering surgery study. Am J Ophthalmol 1993;115:82–92.
Tsai JC, Feuer WJ, Parrish RK 2nd, Grajewski AL: 5-Fluorouracil filtering surgery and neovascular glaucoma. Long-term follow-up of the original pilot study. Ophthalmology 1995;102:887–892.
Katz GH, Higginbotham EJ, Lichiter PR, Skuta GL, Musch DC, Bergstrom TJ, Johnson AT: Mitomycin C versus 5-fluorouracil in high-risk glaucoma filtering surgery. Ophthalmology 1995;102:1263–1269.
Hyung SM, Kim SK: Mid-term effects of trabeculectomy with mitomycin C in neovascular glaucoma patients. Korean J Ophthalmol 2001;15:98–106.
Mandal AK, Majji AB, Mandal SP, Das T, Jalali S, Gothwal VK, Jain SS, Nutheti R: Mitomycin-C-augmented trabeculectomy for neovascular glaucoma. A preliminary report. Indian J Ophthalmol 2002 50:287–293.
May DR, Bergstrom TJ, Parmet AJ, Schwartz JG: Treatment of neovascular glaucoma with transscleral panretinal cryotherapy. Ophthalmology 1980;87:1106–1111.
Shihota R, Sanframouli S, Sood N: A prospective evaluation of anterior retinal cryoablation in neovascular glaucoma. Ophthalmic Surg 1991;22:256–259.
Ohnishi Y, Ishibashi T, Sagawa T: Fluorescein gonioangiography in diabetic neovascularization. Graefes Arch Clin Exp Ophthalmol 1994;232:199–204.
Blankenship GW: The lens influence on diabetic vitrectomy results. Report of a prospective randomized study. Arch Ophthalmol 1980;98:2196–2198.
Rice TA, Michels RG, Maguire MG, Rice EF: The effect of lensectomy on the incidence of iris neovascularization and neovascular glaucoma after vitrectomy for diabetic retinopathy. Am J Ophthalmol 1983;95:1–11.
Aiello LM, Wand M, Liang G: Neovascular glaucoma and vitreous hemorrhage following cataract surgery in patients with diabetis mellitus. Ophthalmology 1983;90:814–820.
Honjo M, Tanihara H, Inatani M, Honda Y: Mitomycin C trabeculectomy in eyes with cicatricial conjunctiva. Am J Ophthalmol 1998;126:823–824.
Sivalingam A, Kenney J, Brown GC, Benson WE, Donoso L: Basic fibroblast growth factor levels in the vitreous of patients with proliferative diabetic retinopathy. Arch Ophthalmol 1990;108:869–872.
Adamis AP: Increased vascular endothelial growth factor levels in the vitreous of eyes with proliferative diabetic retinopathy. Am J Ophthalmol 1994;118:445–450.
Sone H, Okuda Y, Kawakami Y, Hanatani M, Suzuki H, Kozawa T, Honmura S, Yamashita K: Vascular endothelial growth factor level in aqueous humor of diabetic patients with rubeotic glaucoma is markedly elevated [letter]. Diabetic Care 1996;19:1306–1307.
Tripathi RC, Li J, Tripathi BJ, Chalam KV, Adamis AP: Increased level of vascular endothelial growth factor in aqueous humor of patients with neovascular glaucoma. Ophthalmology 1998;105:232–237.
Chen KH, Wu CC, Roy S, Lee SM, Liu JH: Increased interleukin-6 in aqueous humor of neovascular glaucoma. Invest Ophthalmol Vis Sci 1999;40:2627–2632.
Sturmer J, Broadway DC, Hitchings RA: Young patient trabeculectomy. Assessment of risk factors for failure. Ophthalmology 1993;100:928–939.
Mermoud A, Salmon JF: Molteno tube implantation for neovascular glaucoma. Long-term results and factors influencing the outcome. Ophthalmology 1993;100:897–902.
Sidoti PA, Dunphy TR, Baerveldt G, LaBree L, Minckler DS, Lee PP, Heuer DK: Experience with the Baerveldt glaucoma implant in treating neovascular glaucoma. Ophthalmology 1995 ;102:1107–1118.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.