Document Detail


Surgical outcomes of intravitreal bevacizumab and guarded filtration surgery in neovascular glaucoma.
MedLine Citation:
PMID:  19593201     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To assess the efficacy of preoperative intravitreal bevacizumab with guarded filtration surgery and mitomycin C in neovascular glaucoma.
MATERIALS AND METHODS: In this prospective, noncomparative interventional case series, neovascular glaucoma patients who had not responded to or could not receive panretinal photocoagulation were recruited. Patients received 1.25 mg of intravitreal bevacizumab. If needed, the bevacizumab injection was repeated. Patients who could not achieve an intraocular pressure ≤21 mm Hg despite medications underwent trabeculectomy with mitomycin C. Success defined as complete if intraocular pressure was 6 to 21 mm Hg without medication, and qualified if intraocular pressure was within above range with glaucoma medication. Failure was defined as intraocular pressure <6 or >21 mm Hg despite medications or reoperation.
RESULTS: Thirty eyes were treated. All patients demonstrated complete regression of iris neovascularization with 1 or 2 intravitreal bevacizumab injections. The mean intraocular pressure was 43.1 ± 9.3 and 38.9 ± 12.5 before and 2 weeks after bevacizumab injection, respectively (P<0.003). The intraocular pressure in 3 cases was controlled after receiving bevacizumab. In 23 cases that underwent filtering surgery and completed at least 6 months of follow-up, the mean preoperative and last visit intraocular pressure was 43.3 ± 10.0 mm Hg and 20.6 ± 5.4 mm Hg, respectively (P<0.001). The qualified success rate was 61% at final visit. Neither the significant intraoperative nor postoperative complications were noted.
CONCLUSIONS: Preoperative intravitreal bevacizumab combined with guarded filtration surgery with mitomycin C is a safe and effective method of controlling intraocular pressure in neovascular glaucoma.
Authors:
Ghasem Fakhraie; L Jay Katz; Arun Prasad; Yadollah Eslami; Siamak Sabour; Reza Zarei; Sasan Moghimi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of glaucoma     Volume:  19     ISSN:  1536-481X     ISO Abbreviation:  J. Glaucoma     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-10-11     Completed Date:  2010-12-07     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  9300903     Medline TA:  J Glaucoma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  212-8     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiogenesis Inhibitors / administration & dosage*
Antibodies, Monoclonal / administration & dosage*
Antibodies, Monoclonal, Humanized
Combined Modality Therapy
Female
Glaucoma, Neovascular / drug therapy,  physiopathology,  surgery,  therapy*
Humans
Intraocular Pressure / physiology
Intravitreal Injections
Male
Middle Aged
Mitomycin / administration & dosage
Prospective Studies
Trabeculectomy*
Treatment Outcome
Vascular Endothelial Growth Factor A / antagonists & inhibitors
Chemical
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/VEGFA protein, human; 0/Vascular Endothelial Growth Factor A; 2S9ZZM9Q9V/bevacizumab; 50-07-7/Mitomycin

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