Intravitreal bevacizumab with or without mitomycin C trabeculectomy in the treatment of neovascular glaucoma

Marey, Hatem M; Ellakwa, Amin Faisal

doi:10.2147/opth.s21453

Cited by 9 publications

(5 citation statements)

References 21 publications

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“…Another study performed by Ozsutcu et al evaluated the use of an intraoperative bevacizumab injection, with the same dosage, associated with pterygium excision with rotational conjunctival flap followed by another injection after 1 week, reporting significantly less recurrence than rotational flap alone [30]. No side effects related to bevacizumab injection were observed in any previous study [31–33]. …”

Section: Discussionmentioning

confidence: 99%

Efficacy of Subconjunctival Bevacizumab Injections before and after Surgical Excision in Preventing Pterygium Recurrence

Nuzzi

Tridico

2017

Journal of Ophthalmology

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Purpose To evaluate the efficacy of subconjunctival bevacizumab injections, before and after surgical excision with bare sclera technique, in preventing postoperative pterygium recurrence. Material and Methods 83 eyes of 83 patients affected with primary pterygia underwent surgical excision. 42 eyes received two subconjunctival bevacizumab injections, at the dosage of 2.5 mg/0.1 ml, one week prior surgery and one week after intervention. Recurrence rate was evaluated among the two groups. Moreover, modifications of pterygium size and grade one week after the first injection were evaluated. Results At 6 months after surgery, the recurrence rate was 7.14% in the bevacizumab group and 24.39% in the control group. Significant changes of pterygium size and grade were reported after the first injection. No important complications related to bevacizumab subconjunctival injections were registered. Conclusions The application of subconjunctival bevacizumab injections, at the dosage of 2.5 mg/0.1 ml, before and after surgical pterygium excision, may be useful in preventing lesion recurrence after bare scleral procedures. Furthermore, bevacizumab subconjunctival administration is well tolerated and may represent a safer alternative if compared with other surgical techniques and adjunctive drugs. This trial is retrospectively registered with ISRCTN Registry on 18 April 2017, TRN: ISRCTN11424742.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Subconjunctival Bevacizumab Injections before and after Surgical Excision in Preventing Pterygium Recurrence

Nuzzi

Tridico

2017

Journal of Ophthalmology

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“…However, SO tamponade may lead to the elevation of IOP, which probably result in irreversible loss of vision. Marey et al [ 29 ] reported the effect of preoperative IVB injection before trabeculectomy for NVG. The results showed that the mean preoperative IOP dropped from 41.45 ± 5.89 mmHg to 19.3 ± 5.5 mmHg and 17.75 ± 3.74 mmHg at 6 months and 12 months postoperatively, respectively.…”

Section: Discussionmentioning

confidence: 99%

Ranibizumab Plus Combined Surgery for Treatment of Neovascular Glaucoma with Vitreous Hemorrhage

Yang

et al. 2015

Chinese Medical Journal

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Background:Neovascular glaucoma (NVG) is a refractory glaucoma. The management of NVG is very difficult, and it is more difficult when combined with vitreous hemorrhage. The aim of this study was to investigate the effects of ranibizumab plus combined surgery for NVG with vitreous hemorrhage.Methods:A total of 26 eyes of 26 NVG patients with vitreous hemorrhage were recruited in this study. The patients aged from 36 to 63 years with a mean age of 51.97 ± 7.60 years. The mean intraocular pressure (IOP) was 46.38 ± 5.75 mmHg (1 mmHg = 0.133 kPa) while being treated with the maximum medical therapy. The mean best-corrected visual acuities converted to logarithm of the minimum angle of resolution (logMAR BCVA) was 2.62 ± 0.43. All the patients underwent intravitreal injection of 0.5 mg (0.05 ml) ranibizumab combined with pars plana vitrectomy (PPV), pars plana lensectomy (PPL) with a preserved anterior capsule, panretinal photocoagulation (PRP), and trabeculectomy (intravitreal ranibizumab [IVR] + PPV + PPL + PRP + trabeculectomy). The IOP and logMAR BCVA were the main outcome measures in this study.Results:The follow-up period was 12 months. The mean postoperative IOPs were 26.38 ± 3.75 mmHg, 21.36 ± 3.32 mmHg, 18.57 ± 3.21 mmHg, and 16.68 ± 2.96 mmHg, respectively at 7 days, 1 month, 3 months, and 12 months after PPV + PPL + PRP + trabeculectomy. At the last follow-up, the mean IOP was significantly lower than the preoperative one (t = 6.612, P = 0.001). At 7 days, 1 month, 3 months, and 12 months after PPV + PPL + PRP + trabeculectomy, the mean logMAR BCVA were 1.30 ± 0.36, 1.29 ± 0.37, 1.29 ± 0.39, and 1.26 ± 0.29, respectively. At the last follow-up, the mean logMAR BCVA was significantly improved, and the difference was statistically significant compared with preoperative one (t = 6.133, P = 0.002). The logMAR BCVA improved in 22 eyes (84.62%), and remained stable in 4 eyes (15.38%). The neovascularization in the iris and the angle regressed significantly in all patients 7 days after ranibizumab injection. No serious complications occurred during 12 months of the study.Conclusions:IVR + PPV + PPL + PRP + trabeculectomy can control IOP well and improve BCVA without severe complication for NVG patients with vitreous hemorrhage.

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“…Several other studies examining the effect of anti-VEGF on NVG patients found no statistically significant change between trabeculectomy with anti-VEGF to trabeculectomy with MMC or 5-FU. 16,26–32 The success rates of those studies were lower (between 50% and 80% for all groups); however, for cases of NVG, an additional benefit favoring intracameral anti-VEGF was rapid regression of iris neovascularization. 26–28…”

Section: Discussionmentioning

confidence: 97%

Intracameral bevacizumab role in trabeculectomy: A 1-year prospective randomized controlled study

Rabina

Barequet

Kurtz

et al. 2019

European Journal of Ophthalmology

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Purpose: To evaluate the effect of intracameral Bevacizumab on trabeculectomy success rates. Methods: A prospective, randomized, interventional clinical trial. Patients with primary open-angle glaucoma were randomly assigned to two groups: trabeculectomy with mitomycin C and trabeculectomy with mitomycin C and intracameral bevacizumab. Complete success is defined as an intraocular pressure (IOP) reduction of at least 30% from baseline IOP to a measured pressure of between 5 and 18 mm Hg without the use of IOP lowering medications. Qualified success is defined as same achievement of reduced IOP, but with the use of IOP lowering medications. Overall success is defined as same achievement of reduced IOP with or without the use of IOP lowering medications. Results: Thirty-three patients in the mitomycin C group and 36 patients in the mitomycin C and bevacizumab group were included in final analyses. The IOP at presentation was 28.3 ± 8 and 28.4 ± 8.6 mm Hg, compared to 10.8 ± 3.4 and 12.3 ± 3.7 mm Hg at 12 months (p < 0.0001) for the mitomycin C group and the mitomycin C and bevacizumab group, respectively. Complete success at 12 months was achieved in 65% of the mitomycin C group compared to 60% of the mitomycin C and bevacizumab group (p = 0.77). Overall success was achieved in 82% compared to 80% of patients at 12 months (p = 0.78). Both groups showed a statistically significant reduction in IOP after 6 and 12 months (p ⩽ 0.001). There were no statistically significant differences in visual acuity and complications. Conclusion: Intracameral bevacizumab during mitomycin C trabeculectomy in patients with primary open-angle glaucoma apparently does not improve success rates. The adjuvant use of intracameral bevacizumab is therefore not justified.

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Intravitreal bevacizumab with or without mitomycin C trabeculectomy in the treatment of neovascular glaucoma

Cited by 9 publications

References 21 publications

Efficacy of Subconjunctival Bevacizumab Injections before and after Surgical Excision in Preventing Pterygium Recurrence

Efficacy of Subconjunctival Bevacizumab Injections before and after Surgical Excision in Preventing Pterygium Recurrence

Ranibizumab Plus Combined Surgery for Treatment of Neovascular Glaucoma with Vitreous Hemorrhage

Intracameral bevacizumab role in trabeculectomy: A 1-year prospective randomized controlled study

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