Intraocular pressure following combined routes of bevacizumab-augmented trabeculectomy for refractory neovascular glaucoma

• Published in: Seminars in ophthalmology Vol. 28; no. 2; p. 72
• Main Authors: Chatterjee, Susanta, Rao, Aparna
• Format: Journal Article
• Language: English
• Published: England 01.03.2013
• Subjects: Adult; Aged; Angiogenesis Inhibitors - therapeutic use; Antibodies, Monoclonal, Humanized - therapeutic use; Bevacizumab; Combined Modality Therapy; Conjunctiva - drug effects; Glaucoma, Neovascular - drug therapy; Glaucoma, Neovascular - surgery; Glaucoma, Neovascular - therapy; Humans; Intraocular Pressure - physiology; Intravitreal Injections; Male; Middle Aged; Tonometry, Ocular; Trabeculectomy; Vascular Endothelial Growth Factor A - antagonists & inhibitors
• ISSN: 1744-5205
• DOI: 10.3109/08820538.2012.760612

To evaluate the intraocular pressure (IOP) control following combined routes of adjuvant bevacizumab with trabeculectomy in refractory neovascular glaucoma. From June 2011 to December 2011, 5 consecutive cases of neovascular glaucoma with persistent raised IOP on maximal medical treatment underwent adjuvant bevacizumab by combined routes (subconjunctival (SC) and/or intracameral (IC), intravitreal (IV) injections) before pan-retinal photocoagulation (PRP). Needs for repeat procedures or medications for IOP control over the postoperative period were assessed. The mean IOP (1 SC, 1 IC + IV, 3 SC + IC routes) reduced from 40 ± 5.5 mm Hg to 17 ± 3.7 mm Hg at a mean final follow-up of 4 ± 3.7 months (range 1-9 months), respectively (p < 0.001 for each). All eyes had transient IOP spikes 1-3 months after surgery, which normalized spontaneously after PRP, while one eye required topical medications for IOP control. Combined routes of adjuvant bevacizumab augmented trabeculectomy may help in better IOP control (IC + IV > IC + SC > SC) in refractory neovascular glaucoma but require additional procedures for sustained effect.