Effect of Intravitreal Bevacizumab Injection before Ahmed Glaucoma Valve Implantation in Neovascular Glaucoma

Abstract

Purpose: To assess the efficacy of preoperative intravitreal bevacizumab injection (IVB) before Ahmed glaucoma valve (AGV) implantation in the treatment of neovascular glaucoma (NVG). Methods: This retrospective, comparative and consecutive case series study included 41 eyes from 41 patients who underwent AGV implantation for treatment of NVG. The study group was composed of 19 patients (19 eyes) to whom IVB was administered before surgery, while the control group was composed of 22 patients (22 eyes) to whom IVB was not administered before AGV implantation. Findings such as intraocular pressures measured before and after surgery, surgical success rates, and postoperative complications were compared between the groups. Results: There were no significant differences in preoperative data between groups. The surgical success rate in the study group (79%) was better than in the control group (64%), but this difference was not statistically significant (p = 0.28). Early postoperative complications such as fibrinous reaction in the anterior chamber as well as hyphema were less frequently observed in the study group. Conclusions: Intravitreal bevacizumab is a useful preparatory step to safely and effectively implant an aqueous shunting tube in eyes with severe NVG and intractable intraocular pressure.

Beneficial Effects of Adjuvant Intravitreal Bevacizumab Injection on Outcomes of Ahmed Glaucoma Valve Implantation in Patients with Neovascular Glaucoma: Systematic Literature Review

“…The remaining 6 articles with full text that met the inclusion criteria were assessed and included in this systematic literature review. [14][15][16][17][18][19] A flow diagram of the search results is presented in Figure 1. In total, 256 eyes of 252 patients were included in this systematic literature review.…”

Reply: Prophylactic treatment of retinal breaks – a systematic review

“…Concerning the combined therapy (IVB injection plus AGV implantation) for NVG, several papers have been published (Mahdy et al 2013;Sevim et al 2013;Zhou et al 2013;Kang et al 2014). However, of these studies, various researchers carried out the IVB injection at different times.…”

Reversing the Rubeotic Rampage – Current Approaches in the Management of Neovascular Glaucoma

“…Even if secondary closed-angle glaucoma has been established, it may be useful prior to surgery to reduce intra-operative haemorrhage and improve surgical success rates. 8 VEGF levels in the aqueous humour of patients with neovascular glaucoma are known to be 15-20 times that of normal eyes. 9 Intravitreal anti-VEGF is therefore recommended for all stages of neovascular glaucoma.…”