25-Gauge Microincision Vitrectomy to Treat Vitreoretinal Disease in Glaucomatous Eyes after Trabeculectomy

Abstract EN

Purpose.

To determine the feasibility of using 25-gauge microincision vitrectomy surgery (25GMIVS) to treat vitreoretinal disease in glaucomatous eyes which have previously undergone trabeculectomy (TLE).

Methods.

A consecutive, interventional case series.

We performed 25GMIVS in 15 glaucomatous eyes that had undergone TLE.

Follow-up period was 11.5 months.

Results.

25GMIVS was successfully used and led to improvement in visual acuity ( P < 0.01 ).

We performed 25GMIVS for proliferative diabetic retinopathy with neovascular glaucoma in 53% of eyes (8 of 15).

Although 3 eyes needed further TLE following 25GMIVS, final IOP was below 21 mmHg in all eyes except one eye (93%) and was comparable to pre-25GMIVS IOP ( P = 0.20 ) without an increase in the number of glaucoma medications ( P = 0.14 ).

Conclusions.

25GMIVS is a feasible treatment for vitreoretinal disease in eyes with preexisting TLE, effective in both significantly improving BCVA and preserving the filtering bleb, while not excluding further glaucoma surgery.