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Abstract #25600 Published in IGR 12-1
Beneficial effects of preoperative intravitreal bevacizumab on trabeculectomy outcomes in neovascular glaucoma
Saito Y; Higashide T; Takeda H; Ohkubo S; Sugiyama KActa Ophthalmologica 2010; 88: 96-102
Purpose: This study aimed to investigate the effects of preoperative intravitreal bevacizumab (IVB) on outcomes in trabeculectomy for neovascular glaucoma (NVG). Methods: Charts for 52 NVG eyes of 52 consecutive patients who received primary trabeculectomy with mitomycin C (MMC) were reviewed. Postoperative follow-up periods for all patients were (greater-than or equal to) 4 months. Thirty-two consecutive eyes were treated without IVB (control group) and 20 consecutive eyes received IVB (1.25 mg) 10 (plus or minus) 11 days before trabeculectomy (IVB group). The main outcome measures were postoperative intraocular pressure (IOP) and incidence of postoperative complications. Surgical success was defined as IOP< 21 mmHg with or without medication (qualified or complete success, respectively). Failure was defined as IOP exceeding these criteria, phthisis bulbi, loss of light perception or additional glaucoma surgeries. Kaplan-Meier survival analysis with the log-rank test was performed to compare surgical success rates between the two groups. Results: Complete and qualified success rates at 6 months were 95% versus 50% and 95% versus 75% in the IVB and control groups, respectively. The IVB group achieved significantly better surgical success rates than the control group (complete success, p < 0.001; qualified success, p = 0.026). Postoperative hyphaema on day 1 or hyphaema with a duration of > 1 week occurred significantly less frequently in the IVB group than in the control group (p = 0.009, p = 0.014, respectively). The incidence of serious complications such as endophthalmitis, phthisis bulbi and a marked decrease in visual acuity did not increase in the IVB group. Conclusions: This retrospective study showed that preoperative IVB decreased postoperative hyphaema and increased surgical success rates, and thus may be an effective adjunct to trabeculectomy in NVG.
T. Higashide. Department of Ophthalmology and Visual Science, Kanazawa University, Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa 920-8641, Japan. eyetomo@kenroku.kanazawa-u.ac.jp
Classification:
9.4.5.1 Neovascular glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous)
11.15 Other drugs in relation to glaucoma (Part of: 11 Medical treatment)
