Presented at ARVO 2012, Fort Lauderdale, FL, USA.
Efficacy and safety of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing ahmed glaucoma valve implantation: 2-year follow-up
Article first published online: 2 JUL 2014
© 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd
Volume 93, Issue 1, pages e1–e6, February 2015
How to Cite
Arcieri, E. S., Paula, J. S., Jorge, R., Barella, K. A., Arcieri, R. S., Secches, D. J. and Costa, V. P. (2015), Efficacy and safety of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing ahmed glaucoma valve implantation: 2-year follow-up. Acta Ophthalmologica, 93: e1–e6. doi: 10.1111/aos.12493
- Issue published online: 23 JAN 2015
- Article first published online: 2 JUL 2014
- Manuscript Accepted: 29 MAY 2014
- Manuscript Received: 5 OCT 2013
- glaucoma drainage implants;
- intraocular pressure;
To evaluate the efficacy and safety of intravitreal bevacizumab (IVB) in eyes with neovascular glaucoma (NVG) undergoing Ahmed glaucoma valve (AGV) implantation.
This was a multicentre, prospective, randomized clinical trial that enrolled 40 patients with uncontrolled neovascular glaucoma that had undergone panretinal photocoagulation and required glaucoma drainage device implantation. Patients were randomized to receive IVB (1.25 mg) or not during Ahmed valve implant surgery. Injections were administered intra-operatively, and 4 and 8 weeks after surgery.
After a mean follow-up of 2.25 ± 0.67 years (range 1.5–3 years), both groups showed a significant decrease in IOP (p < 0.05). There was no difference in IOP between groups except at the 18-month interval, when IOP in IVB group was significantly lower (14.57 ± 1.72 mmHg vs. 18.37 ± 1.06 mmHg – p = 0.0002). There was no difference in survival success rates between groups. At 24 months, there was a trend to patients treated with IVB using less antiglaucoma medications than the control group (p = 0.0648). Complete regression of rubeosis iridis was significantly more frequent in the IVB group (80%) than in the control group (25%) (p = 0.0015).
Intravitreal bevacizumab may lead to regression of new vessels both in the iris and in the anterior chamber angle in patients with neovascular glaucoma undergoing Ahmed glaucoma valve implantation. There is a trend to slightly lower IOPs and number of medications with IVB use during AGV implantation for neovascular glaucoma.