Intravitreal bevacizumab and Ahmed glaucoma valve implantation in patients with neovascular glaucoma
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(1.Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang 410-773, South Korea;2.Department of Ophthalmology, Korea University College of Medicine, Seoul 136-705, South Korea)

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None.
Conflicts of Interest: Zhang HT, None; Yang YX, None; Xu YY, None; Yang RM, None; Wang BJ, None; Hu JX, None.

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    Abstract:

    AIM:To explore the efficacy of preoperative intravitreal bevacizumab (IVB) injection combined with Ahmed glaucoma valve (AGV) implantation in the treatment of neovascular glaucoma (NVG).METHODS: This retrospective study included 35 eyes from 35 patients who underwent preoperative IVB and AGV implantation for treatment of NVG. Findings such as intraocular pressure (IOP) number of anti-glaucoma medications, visual acuity (VA), surgical success rates, and complications were recorded.RESULTS: After AGV implantation, IOP was 18.2±4.0 mm Hg, 15.5±3.3 mm Hg and 9.8±2.6 mm Hg at 6, 12 and 36mo, significantly decreased compared with pre-IOP (P<0.01). The number of anti-glaucoma medications was 0.9±0.5, 0.8±0.9 and 0.8±0.6 at 6, 12 and 36mo, significantly decreased compared to pre-treatment (P<0.01). At last visit, there were 19 eyes with stable VA, 4 with VA improvement, 12 with diminished VA and 3 with complete loss light perception. There were 7 cases that failed during 3-year fellow up period. Cumulative probabilities of valve survival by Kaplan-Meier analysis were 82.9%, 74.1% and 71.0% at 12, 24 and 36mo, respectively. Cox stepwise regression analysis found that the survival time was significant associated with the pre-visual acuity <2/400 (P<0.05). Post-operative complications occurred in 8 eyes, of which hyphema presented in 2 eyes, choroidal effusion in 2 eyes.CONCLUSION: The procedure of preoperative IVB and AGV implantation should be one of treatments for NVG because of its safety and effectiveness.

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Hai-Tao Zhang, Yu-Xin Yang, Ying-Ying Xu, et al. Intravitreal bevacizumab and Ahmed glaucoma valve implantation in patients with neovascular glaucoma. Int J Ophthalmol, 2014,7(5):837-842

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History
  • Received:November 04,2013
  • Revised:January 25,2014
  • Adopted:January 25,2014
  • Online: October 20,2014
  • Published: