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The effect of subconjunctival bevacizumab as an adjunct to ahmed glaucoma valve implantation in eyes with neovascular glaucoma

Authors:Shifa A. Alrabadi, MD
Int J Biol Med Res. 2016; 7(3): 5622-5624  |  PDF File

Abstract

Aim: to evaluate the effect of Subconjunctival Bevacizumab as an Adjunct to Ahmed glaucoma valve implantation in eyes with Neovascular glaucoma. Method: This is a retrospective study conducted in Irbid-Jordan at prince Rashid Bin Al Hassan military hospital between Jan. 2012 and May 2016. All patients who underwent Ahmed glaucoma valve surgery to control refractory Neovascular glaucoma were included in the study. 50 eyes were included in the study. Patients were divided into 2 groups; Group A (32 eyes) are those eyes who underwent Subconjunctival 1.25mg Bevacizumab as an Adjunct to Ahmed glaucoma valve surgery and group B (18 eyes) are those who underwent Ahmed glaucoma valve surgery without Subconjunctival Bevacizumab. Information was collected from patients regarding their age, sex, cause of NVG, number of eye drops before and after surgery, visual acuity, level of IOP before and after surgery and severity of rubeosis iridis before and after surgery. Results: after the use of Subconjunctival Bevacizumab the IOP level in group A was 18.1,16.0, 13.6 and 12.9 mmhg at 1 week, 4 weeks, 3 months and 6 months respectively compared with 22.3, 21.0, 19.2 and 19.1 mmhg in group B for the same period( P value < 0.05). Also, the number of medication needed post-operatively to control IOP in group A was 3.2, 2.1, 1.1 and 0.5 at 1 week, 4 weeks, 3 months and 6 months respectively compared with 3.8, 3.0, 2.8 and 2 in group B for the same period. Conclusion: Subconjunctival Bevacizumab has an excellent additive effect in regression of rubeosis iridis and achievement of better intra ocular pressure control when administered at the time of Ahmed glaucoma valve surgery in patients with neovascular glaucoma and it significantly increases the success rate of the surgery.