Rapid-onset neovascular glaucoma following cataract surgery in diabetes: outcomes of pars plana vitrectomy combined with Ahmed glaucoma valve implantation
AIM: To present a case series of rapid-onset neovascular glaucoma (NVG) accompanied by vitreous haemorrhage (VH) following cataract surgery in diabetic patients, and to evaluate the efficacy of pars plana vitrectomy (PPV) combined with Ahmed glaucoma valve (AGV) implantation. METHODS: This is a retr...
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Press of International Journal of Ophthalmology (IJO PRESS)
2025-09-01
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| Series: | International Journal of Ophthalmology |
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| Online Access: | http://ies.ijo.cn/en_publish/2025/9/20250907.pdf |
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| author | Hui-Ping Yao Ya-Nuo Wang Yan-Wei Chen Sha Gao Yi-Sheng Zhong Xi Shen |
| author_facet | Hui-Ping Yao Ya-Nuo Wang Yan-Wei Chen Sha Gao Yi-Sheng Zhong Xi Shen |
| author_sort | Hui-Ping Yao |
| collection | DOAJ |
| description | AIM: To present a case series of rapid-onset neovascular glaucoma (NVG) accompanied by vitreous haemorrhage (VH) following cataract surgery in diabetic patients, and to evaluate the efficacy of pars plana vitrectomy (PPV) combined with Ahmed glaucoma valve (AGV) implantation. METHODS: This is a retrospective, single-center, consecutive case series. All patients underwent 23-gauge PPV with AGV implantation 2–3d after intravitreal ranibizumab injection (IVR). The minimum postoperative follow-up period lasted 12mo. The primary outcome measures included best-corrected visual acuity (BCVA), intraocular pressure (IOP), and topical hypotensive medications. RESULTS: Fifteen diabetic patients (age, 46–81y) with rapid-onset NVG and VH following uncomplicated phacoemulsification were included. The median time to the initial NVG diagnosis following cataract surgery was within 4wk. After PPV combined with AGV implantation, the mean BCVA (logMAR) improved from 1.9 (range: 1.0 to 2.6) preoperatively to 1.2 (range: 0.2 to 2.6) at the final follow-up. Baseline BCVA and the presence of diabetic nephropathy (DN) were significantly associated with the final BCVA in the multiple regression model. The mean postoperative IOP at all follow-up visits was significantly reduced compared to baseline. At the final follow-up, 9 patients required one or two topical ocular hypotensive medications, while the other 6 needed not. Success was achieved in 87%, and the reoperation rate was 20%. The majority of NVG cases (9/15) were primarily attributed to the rapid progression of proliferative diabetic retinopathy. However, a notable subset (6 eyes) was complicated retinal vein occlusion or carotid artery occlusion. CONCLUSION: PPV combined with AGV implantation after adjuvant IVR for rapid-onset NVG with VH following diabetic cataract surgery is one of the safe and effective treatments. Baseline BCVA and preexisting DN may be potential indicators for visual outcomes. |
| format | Article |
| id | doaj-art-af9e5fdcf574485d923830da4378d57b |
| institution | Kabale University |
| issn | 2222-3959 2227-4898 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Press of International Journal of Ophthalmology (IJO PRESS) |
| record_format | Article |
| series | International Journal of Ophthalmology |
| spelling | doaj-art-af9e5fdcf574485d923830da4378d57b2025-08-22T06:07:08ZengPress of International Journal of Ophthalmology (IJO PRESS)International Journal of Ophthalmology2222-39592227-48982025-09-011891665167210.18240/ijo.2025.09.0720250907Rapid-onset neovascular glaucoma following cataract surgery in diabetes: outcomes of pars plana vitrectomy combined with Ahmed glaucoma valve implantationHui-Ping Yao0Ya-Nuo Wang1Yan-Wei Chen2Sha Gao3Yi-Sheng Zhong4Xi Shen5Xi Shen and Yi-Sheng Zhong. Department of Ophthalmology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China. carl_shen2005@126.com; yszhong68@126.comDepartment of Ophthalmology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;Co-first Authors: Hui-Ping Yao and Ya-Nuo WangDepartment of Ophthalmology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;Co-first Authors: Hui-Ping Yao and Ya-Nuo WangDepartment of Ophthalmology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;Co-first Authors: Hui-Ping Yao and Ya-Nuo WangDepartment of Ophthalmology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;Co-first Authors: Hui-Ping Yao and Ya-Nuo WangDepartment of Ophthalmology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;Co-first Authors: Hui-Ping Yao and Ya-Nuo WangAIM: To present a case series of rapid-onset neovascular glaucoma (NVG) accompanied by vitreous haemorrhage (VH) following cataract surgery in diabetic patients, and to evaluate the efficacy of pars plana vitrectomy (PPV) combined with Ahmed glaucoma valve (AGV) implantation. METHODS: This is a retrospective, single-center, consecutive case series. All patients underwent 23-gauge PPV with AGV implantation 2–3d after intravitreal ranibizumab injection (IVR). The minimum postoperative follow-up period lasted 12mo. The primary outcome measures included best-corrected visual acuity (BCVA), intraocular pressure (IOP), and topical hypotensive medications. RESULTS: Fifteen diabetic patients (age, 46–81y) with rapid-onset NVG and VH following uncomplicated phacoemulsification were included. The median time to the initial NVG diagnosis following cataract surgery was within 4wk. After PPV combined with AGV implantation, the mean BCVA (logMAR) improved from 1.9 (range: 1.0 to 2.6) preoperatively to 1.2 (range: 0.2 to 2.6) at the final follow-up. Baseline BCVA and the presence of diabetic nephropathy (DN) were significantly associated with the final BCVA in the multiple regression model. The mean postoperative IOP at all follow-up visits was significantly reduced compared to baseline. At the final follow-up, 9 patients required one or two topical ocular hypotensive medications, while the other 6 needed not. Success was achieved in 87%, and the reoperation rate was 20%. The majority of NVG cases (9/15) were primarily attributed to the rapid progression of proliferative diabetic retinopathy. However, a notable subset (6 eyes) was complicated retinal vein occlusion or carotid artery occlusion. CONCLUSION: PPV combined with AGV implantation after adjuvant IVR for rapid-onset NVG with VH following diabetic cataract surgery is one of the safe and effective treatments. Baseline BCVA and preexisting DN may be potential indicators for visual outcomes.http://ies.ijo.cn/en_publish/2025/9/20250907.pdfdiabetic retinopathyneovascular glaucomapars plana vitrectomyahmed glaucoma valve implantation |
| spellingShingle | Hui-Ping Yao Ya-Nuo Wang Yan-Wei Chen Sha Gao Yi-Sheng Zhong Xi Shen Rapid-onset neovascular glaucoma following cataract surgery in diabetes: outcomes of pars plana vitrectomy combined with Ahmed glaucoma valve implantation International Journal of Ophthalmology diabetic retinopathy neovascular glaucoma pars plana vitrectomy ahmed glaucoma valve implantation |
| title | Rapid-onset neovascular glaucoma following cataract surgery in diabetes: outcomes of pars plana vitrectomy combined with Ahmed glaucoma valve implantation |
| title_full | Rapid-onset neovascular glaucoma following cataract surgery in diabetes: outcomes of pars plana vitrectomy combined with Ahmed glaucoma valve implantation |
| title_fullStr | Rapid-onset neovascular glaucoma following cataract surgery in diabetes: outcomes of pars plana vitrectomy combined with Ahmed glaucoma valve implantation |
| title_full_unstemmed | Rapid-onset neovascular glaucoma following cataract surgery in diabetes: outcomes of pars plana vitrectomy combined with Ahmed glaucoma valve implantation |
| title_short | Rapid-onset neovascular glaucoma following cataract surgery in diabetes: outcomes of pars plana vitrectomy combined with Ahmed glaucoma valve implantation |
| title_sort | rapid onset neovascular glaucoma following cataract surgery in diabetes outcomes of pars plana vitrectomy combined with ahmed glaucoma valve implantation |
| topic | diabetic retinopathy neovascular glaucoma pars plana vitrectomy ahmed glaucoma valve implantation |
| url | http://ies.ijo.cn/en_publish/2025/9/20250907.pdf |
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