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Surgical results of Ahmed valve implantation with intraoperative bevacizumab injection in patients with neovascular glaucoma

Authors
 Ma, Kyoung Tak  ;  Yang, Jong Yun  ;  Kim, Ji Hyun  ;  Kim, Na Rae  ;  Hong, Samin  ;  Lee, Eun Suk  ;  Seong, Gong Je  ;  Kim, Chan Yun 
Citation
 JOURNAL OF GLAUCOMA, Vol.21(5) : 331-336, 2012 
Journal Title
JOURNAL OF GLAUCOMA
ISSN
 1057-0829 
Issue Date
2012
MeSH
Angiogenesis Inhibitors/administration & dosage* ; Antibodies, Monoclonal, Humanized/administration & dosage* ; Bevacizumab ; Combined Modality Therapy ; Female ; Glaucoma Drainage Implants* ; Glaucoma, Neovascular/drug therapy ; Glaucoma, Neovascular/surgery ; Glaucoma, Neovascular/therapy* ; Humans ; Intraocular Pressure/physiology ; Intraoperative Care ; Intravitreal Injections ; Male ; Middle Aged ; Prosthesis Implantation ; Retrospective Studies ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity/physiology
Keywords
neovascular glaucoma ; intraoperative intravitreous bevacizumab injection ; Ahmed valve implantation
Abstract
PURPOSE: To investigate the surgical results of Ahmed valve implantation with intraoperative bevacizumab injection in patients with neovascular glaucoma (NVG).

METHODS: A retrospective comparative case series review was conducted on 52 eyes with NVG who underwent Ahmed glaucoma valve implantation with or without intraoperative bevacizumab intravitreal injection. In the intraoperative intravitreous bevacizumab injection group (IVB group, 20 eyes), 1.25 mg of bevacizumab was injected into the vitreous cavity during Ahmed valve implantation. In the control group (32 eyes), only Ahmed valve implantation was performed. Surgical failure was defined when (1) the postoperative intraocular pressure was over 21 mm Hg at consecutive clinic visits, (2) the visual acuity became light perception negative, (3) additional antiglaucomatic surgery was required, or (4) devastating operative or postoperative complications were noted.

RESULTS: Although the success rate in the IVB group (70.0%) was higher than that in the control group (62.5%) 1 year after operation, the differences were not statistically significant (P=0.828 by log-rank test). Mean intraocular pressures in the IVB group were significantly lower than those of the control group at 12 and 15 months (P<0.05 by the Mann-Whitney U test). Postoperative complications were similar between the 2 groups. Preoperative history of trabeculectomy was a significant risk factor for surgical failure of Ahmed valve implantation in NVG (relative risk=4.618; P=0.018 by Cox regression model).

CONCLUSIONS: Intraoperative IVB injection does not seem to be helpful for better surgical outcomes of Ahmed valve implantation in NVG. A history of trabeculectomy is a risk factor for failure after Ahmed valve implantation in patients with NVG.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00061198-201206000-00008&LSLINK=80&D=ovft
DOI
10.1097/IJG.0b013e31820e2fd0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Na Rae(김나래)
Kim, Ji Hyun(김지현)
Kim, Chan Yun(김찬윤) ORCID logo https://orcid.org/0000-0002-8373-9999
Seong, Gong Je(성공제) ORCID logo https://orcid.org/0000-0002-5456-4296
Lee, Eun Suk(이은석)
Hong, Sa Min(홍사민)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90838
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