To evaluate the efficacy of intravitreal bevacizumab and subsequent trabeculectomy with mitomycin C (MMC) for neovascular glaucoma (NVG) in eyes that underwent previous 23-gauge transconjunctival sutureless vitrectomy (TSV).

This was a retrospective, comparative, and consecutive case series study. We reviewed the medical records of patients with NVG who underwent trabeculectomy with MMC after intravitreal bevacizumab (1.25 mg/0.05 mL) injection and compared the surgical outcomes according to 23-gauge TSV history. Surgical success was defined as an intraocular pressure (IOP) of ≥6 mm Hg and ≤21 mm Hg without additional glaucoma surgery or loss of light perception. The main outcome measures were postoperative IOP control, visual acuity, and complications.

A total of 27 patients (27 eyes) were included; 12 patients with 23-gauge TSV history (TSV group) and 15 patients without vitrectomy history (nonvitrectomized group). The cumulative probability of success after trabeculectomy with MMC was 82.5% and 73.3% after one year for the TSV group and the nonvitrectomized group, respectively ( p = 0.523). Mean IOP decreased from 37.3 ± 9.0 mm Hg preoperatively to 12.8 ± 6.2 mmHg at the final visit in the TSV group ( p = 0.002). Mean IOP decreased from 40.3 ± 9.7 mm Hg preoperatively to 17.8 ± 11.7 mm Hg at the final visit in the nonvitrectomized group ( p = 0.001). Preoperative and final IOP were not significantly different between the two groups. Complications were comparable between the groups.

Intravitreal bevacizumab injection and subsequent trabeculectomy with MMC is an effective method for controlling IOP in patients with NVG associated with sutureless vitrectomy.