Rubeosis iridis and neovascular glaucoma: II. Our own experiences with the treatment by cryocoagulation

Abstract

The author evaluates the effect of two cryosurgical methods on the development of rubeosis iridis in neovascular glaucoma. In 12 eyes, cyclo-cryocoagulation was used as a single method, in 26 eyes, trans-scleral panretinal cryocoagulation was used in combination with cyclo-cryocoagulation in one session. Markedly better results were achieved by using the combined cryosurgical method. When trans-scleral panretinal cryocoagulation was applied in combination with cyclo-cryocoagulation, all the patients showed, 6 weeks postoperatively, a marked involution of rubeosis iridis. Complete regression of rubeosis iridis after cyclo-cryocoagulation was achieved only in one eye. The insufficient regression of rubeosis iridis in neovascular glaucoma, after the performance of single cyclo-cryocoagulation, the author explains in that way that by this surgical method only one component in the pathogenesis of rubeosis iridis is resolved. The author assumes that in the pathogenesis of rubeosis iridis in neovascular glaucoma, two components play their role: not only the underlying disease which conditions the development of proliferative retinopathy but also the high intraocular pressure which reduces the blood-flow in the retinal bed and thus increases retinal hypoxia.