gms | German Medical Science

The intraocular pressure (IOP) can be very high in neovascular glaucoma. Therefor a rapid IOP decrease is desirable, although this is not easy to achieve as surgical proceedings at the anterior chamber are associated with a high complication rate in presence of active rubeosis iridis and high IOP. We performed an aspiration of chamber liquid with a 27-gauge needle through pars plana in 7 eyes with neovascular glaucoma and IOP >50 mmHg. In 5 eyes the aspiration of 0.2 to 0.5 ml was uncomplicated, in 1 case only 0.05 ml could be aspirated and was combined with anterior chamber paracenthese, in 1 case no liquid could be aspirated. The peripheral retina was cryocoagulated in all patients und in 6 of 7 eyes we injected bevacizumab. We could observe blood and fibrin in the anterior chamber as a effect of the rapid IOP decrease immediatly after the procedure, which resorbed spontaniously in short time. Later on 2 patients were treated with a fistulated operation and 1 patient had a cryocoagulation of the ciliary body.In our opinion the aspiration of chamber liquid through pars plana is a reasonable procedure in neovascular glaucoma with high IOP allowing a rapid IOP decrease and a anti-VEGF-Injection without another IOP elevation.