Long-term results of Ahmed glaucoma valve in association with intravitreal bevacizumab in neovascular glaucoma

J Glaucoma. 2015 Jun-Jul;24(5):383-8. doi: 10.1097/IJG.0000000000000234.

Abstract

Purpose: Evaluate the long-term results of the Ahmed glaucoma valve (AGV) surgery in association with bevacizumab (Avastin) in neovascular glaucoma (NVG) patients.

Design and methods: This retrospective institutional study reviewed 39 eyes of 34 patients with NVG who underwent AGV implantation. The intravitreal bevacizumab (IVB) group included 19 eyes that received an injection of IVB 7 days preoperatively, whereas the no-IVB group included 20 eyes that did not receive any antivascular endothelial growth factor therapy. Findings such as intraocular pressure (IOP), number of antiglaucoma medications, best-corrected visual acuity (BCVA), and surgical outcomes were reviewed over a period of 5 years.

Results: There were no significant differences in the preoperative characteristics between the 2 groups. At last follow-up visit, IOP was 16.37±5.72 mm Hg in the IVB group and 20.05±9.75 mm Hg in the no-IVB group (P=0.16). The number of postoperative antiglaucoma medications was significantly lower in the IVB group (P=0.02). Last visit's mean BCVA was 2.34±1.00 logMAR in the IVB group and 2.66±1.04 logMAR in the control group (P=0.33). Hyphema was significantly less observed in the IVB group (P=0.02). The probability of success was 63.2% in the IVB group and 70.0% in the control group (P=0.37).

Conclusions: Preoperative IVB before AGV was not associated with a better surgical success, IOP control, or BCVA. Its administration significantly decreased postoperative hyphema and number of last visit's antiglaucoma medications.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antihypertensive Agents / therapeutic use
  • Bevacizumab
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Glaucoma Drainage Implants*
  • Glaucoma, Neovascular / drug therapy
  • Glaucoma, Neovascular / physiopathology
  • Glaucoma, Neovascular / surgery
  • Glaucoma, Neovascular / therapy*
  • Humans
  • Intraocular Pressure / physiology
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tonometry, Ocular
  • Visual Acuity / physiology

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Antihypertensive Agents
  • Bevacizumab