Clinical Ophthalmology (Aug 2017)

Glaucoma drainage device implantation with adjunctive intravitreal bevacizumab in neovascular glaucoma: 3-year experience

  • Noor NA,
  • Mustafa S,
  • Artini W

Journal volume & issue
Vol. Volume 11
pp. 1417 – 1422

Abstract

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Nina Asrini Noor,1 Syukri Mustafa,1,2 Widya Artini1,2 1Ophthalmology Department, 2Glaucoma Division, Ophthalmology Department, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia Purpose: To evaluate the outcome of glaucoma drainage device (GDD) implantation with and without intravitreal bevacizumab (IVB) injection in treating neovascular glaucoma (NVG) at Cipto Mangunkusumo Hospital Jakarta, Indonesia.Patients and methods: This retrospective study involved 39 eyes with NVG which underwent GDD implantation between 2012 and 2014. Thirty eyes underwent GDD implantation alone (control group) while 9 eyes underwent GDD implantation and IVB injection (IVB group). Visual acuity (VA), intraocular pressure (IOP), number of antiglaucoma medications, and success rate were compared between groups.Results: There were no significant differences in preoperative characteristics. On the last visit, VA was 2.6 (0.2–4.0) logMAR in the control group and 2.3 (0.4–4.0) logMAR in the IVB group (P=0.97). In the control group, final VA was significantly worse compared to initial VA (P<0.01), while in IVB group VA was apparently stable (P=0.24). Final IOP was 16.3±10.3 mmHg in the control group and 12.0 (2.0–49.0) mmHg in IVB group (P=0.40). The number of antiglaucoma medications was similar between groups (P=0.57). Surgical success rate in the IVB group (66.7%) was better than the control group (56.7%), but this difference was not statistically significant (P=0.71). Kaplan–Meier survival analysis showed the probability of success 37 months after surgery as 53.6% in the IVB group and 31.6% in the control group. No significant difference was found between the groups (P=0.45).Conclusion: In cases of NVG, GDD combined with IVB could maintain VA compared to GDD alone. However, there were no significant differences in final IOP, number of antiglaucoma medications, and surgical success rate. Keywords: Ahmed glaucoma valve, Baerveldt implant, glaucoma surgery, vascular endothelial growth factor, VEGF 

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