Efficacy and safety of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing ahmed glaucoma valve implantation: 2‐year follow‐up

Abstract

ABSTRACT.Purpose: To evaluate the efficacy and safety of intravitreal bevacizumab (IVB) in eyes with neovascular glaucoma (NVG) undergoing Ahmed glaucoma valve (AGV) implantation. Methods: 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. Results: After a mean follow-up of 2.25 AE 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 AE 1.72 mmHg vs. 18.37 AE 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). Conclusions: 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.

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.…”

Effect of Preoperative Intravitreal Bevacizumab on the Surgical Outcome of Neovascular Glaucoma at Different Stages

“…Many reports have been published about the effect of intravitreal bevacizumab (IVB) injection on NVG [5–14]. Adjuvant IVB injection may lead to regression of NV in the iris and angle, thus, reducing the incidence of hyphema and potentially enhancing the surgical outcome of Ahmed glaucoma valve (AGV) implantation in NVG [10, 12]. However, its role in treating NVG is currently limited.…”

Intraocular Pressure Control after Implantation of an Ahmed Glaucoma Valve in Eyes with a Failed Trabeculectomy

“…7-16 Studies that specifically measured the performance of this procedure in adults with primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) that had a failed trabeculectomy were not found in the literature. The efficacy and safety of the AGV in this situation are not well established, and this information would be valuable when making surgical decisions.…”