Intravitreal bevacizumab and Ahmed glaucoma valve implantation in patients with neovascular glaucoma

• Published in: International journal of ophthalmology Vol. 7; no. 5; pp. 837 - 842
• Main Authors: Zhang, Hai-Tao, Yang, Yu-Xin, Xu, Ying-Ying, Yang, Rui-Min, Wang, Bao-Jun, Hu, Jun-Xi
• Format: Journal Article
• Language: English
• Published: China International Journal of Ophthalmology Press 18.10.2014; Press of International Journal of Ophthalmology (IJO PRESS)
• Subjects: Ahmed; Ahmed glaucoma valve; bevacizumab; Clinical Research; glaucoma; injection; intravitreal; intravitreal injection; neovascular; neovascular glaucoma; valve; bevacizumab; intravitreal injection; Ahmed glaucoma valve; neovascular glaucoma
• ISSN: 2222-3959; 2227-4898
• DOI: 10.3980/j.issn.2222-3959.2014.05.18

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:AfterAGVimplantation,IOPwas18.2±4.0mmHg,15.5±3.3 mm Hg and 9.8±2.6 mm Hg at 6, 12 and 36 mo,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 36 mo, 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 36 mo, 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 8eyes, of which hyphema presented in 2 eyes, choroidal effusion in 2 eyes.CONCLUSION:The procedure of preoperative IVB andAGV implantation should be one of treatments for NVG because of its safety and effectiveness.