Abstract: 【Abstract】 Objective To study the efficacy of combining treatment based on clinical stage for neovascular glaucoma (NVG). Design Retrospective case series. Participants Sixty-nine eyes of 63 cases with NVG were divided into 3 groups: the iris neovascularization (INV) group (16 eyes of 15 cases), the NVG with open angle (O-NVG) group (22 eyes of 20 cases) and the NVG with angle closure (C-NVG) group (31 eyes of 28 cases). Methods In the INV group, panretinal photocoagulation (PRP) were done in all cases, of which 3 eyes underwent cataract surgery and 1 eye received intravitreal bevacizumab. In the O-NVG group, anti-glaucoma drug was used based on PRP.  8 eyes of 22 eyes underwent trabeculectomy, 4 eyes received cataract surgery, 2 eyes combining vitrectomy and 5 eyes required intravitreal bevacizumab. In the C-NVG group, bevacizumab was injected into the vitreous based on PRP, trabeculectomy or cyclophotocoagulation; in which 21 eyes underwent combining vitrectomy and cataract surgery, 12 eyes received silicone oil tamponade. All cases were followed up for 18.6±15.3 months. Main Outcome Measures Intraocular pressure(IOP), visual acuity, iris neovascularization, anterior chamber angle and complications. Results The number of the eyes with invariability or improvement of visual acuity after treatment in INN, O-NVG and C-NVG group was 15(93.8%), 17(77.3%) and 16(51.6%)  respectively(χ2=9.76, P<0.01). The IOP before treatment in the three groups was (14.6±3.8) mmHg, (31.6±9.1) mmHg and（44.8±12.2）mmHg , respectively. The IOP after treatment was (14.1±3.6)mmHg, (17.9±3.9) mmHg and (18.9±10.8) mmHg respectively(F=185.8, P<0.001). Iris neovascularization after treatment disappeared in all eyes of the INV group, in 20/22 eyes of the O-NVG group and in 28/31 of the C-NVG group. The anterior chamber angle after treatment was still wide in the INV group. The range of open angle after treatment was larger than before treatment in 18/22 eyes of the O-NVG group because of atrophy of neovascular membrane in the angle, while in the C-NVG group, the range of open angle was same as before treatment, though the neovascular membrane appeared different degree of atrophy. The incidence of the complications after treatment in the three groups was 6.3%, 22.7% and 48.4%, respectively (χ2=9.75, P<0.01). Conclusion Efficacy of combining treatment based on clinical stage in NVG especially for early and intermediate stage is good. (Ophthalmol CHN, 2012, 21: 268-272)

Key words: neovascular glaucoma/treatment, iris neovascularization