Management of neovascular glaucoma

Neovascular glaucoma is a refractory glaucoma associated with a significant risk of blindness. The first line of treatment is ablation of retina to lessen retinal ischemia. The combination of bevacizumab and panretinal photocoagulation is effective in preventing progression of neovascular glaucoma. The adjunctive use of bevacizumab also reduces the risk of postoperative hyphema after filtering surgery. Prior vitrectomy in these eyes more frequently results in bleb failure after trabeculectomy. Advances in minimally invasive vitreous surgery reduce conjunctival scar formation, which can be beneficial if further filtering surgery is required. Pars plana implantation of glaucoma drainage devices is also an option for the reduction of intraocular pressure in vitrectomized eyes with neovascular glaucoma.