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

• Main Authors: Hai-Tao Zhang, Yu-Xin Yang, Ying-Ying Xu, Rui-Min Yang, Bao-Jun Wang, Jun-Xi Hu
• Format: Article
• Language: English
• Published: Press of International Journal of Ophthalmology (IJO PRESS) 2014-10-01
• Series: International Journal of Ophthalmology
• Subjects: Ahmed glaucoma valve; bevacizumab; intravitreal injection; neovascular glaucoma
• Online Access: http://www.ijo.cn/en_publish/2014/5/20140518.pdf
• ISSN: 2222-3959; 2227-4898

<b>AIM:</b>To explore the efficacy of preoperative intravitreal bevacizumab (IVB) injection combined with Ahmed glaucoma valve (AGV) implantation in the treatment of neovascular glaucoma (NVG).<b>METHODS:</b> 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.<b>RESULTS:</b> 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 (<i>P&lt;</i>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 (<i>P&lt;</i>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 &lt;2/400 (<i>P&lt;</i>0.05). Post-operative complications occurred in 8 eyes, of which hyphema presented in 2 eyes, choroidal effusion in 2 eyes.<b>CONCLUSION:</b> The procedure of preoperative IVB and AGV implantation should be one of treatments for NVG because of its safety and effectiveness.