Effect of combined therapy based on transscleral peripheral retinal cryotherapy in the treatment of open-angle neovascular glaucoma: a retrospective study

Abstract

Backgrounds

This study aims to describe and evaluate the efficacy of transscleral peripheral retinal cryotherapy (TPRC) combined with other intraocular pressure (IOP)-lowering treatments in patients with open-angle neovascular glaucoma (NVG).

Methods

A retrospective observational case series was conducted, including 16 eyes from 16 patients with open-angle NVG, treated with combinations of TPRC and IOP-lowering eyedrops, TPRC and cyclocryotherapy, or TPRC and transscleral ciliary photocoagulation (TCP) over a 4-year period (01/2020-01/2024). Preoperative, intraoperative data, and postoperative data at day 1, week 1, and months 1, 6, and 12 were systematically collected.

Results

The primary causes of NVG were proliferative diabetic retinopathy (68.75%) and central retinal vein occlusion (31.25%). The mean (± SD) pre-treatment IOP was 36.56 ± 6.73 mmHg, decreasing to 14.81 ± 2.59 mmHg at 12 months of follow-up. The mean (± SD) best-corrected visual acuity (BCVA) in LogMAR was 2.25 ± 0.8 at baseline, improving to 1.81 ± 0.50 at 12 months. All patients demonstrated a reduction in iris neovascularization following TPRC. No serious complications were observed.

Conclusions

TPRC-based IOP-lowering combination therapies appear to be an effective treatment option for open-angle NVG. These approaches may be particularly suitable for primary healthcare settings, hospitals without advanced glaucoma surgery capabilities, or NVG patients with limited economic resources and extremely elevated IOP.