J Korean Ophthalmol Soc.  2013 May;54(5):757-765. 10.3341/jkos.2013.54.5.757.

Long-Term Results of Ahmed Valve Implantation in Neovascular Glaucoma and the Effects of Intracameral Bevacizumab

• Kim JJ
• Shin JP

• KMID: 2217042
• DOI: http://doi.org/10.3341/jkos.2013.54.5.757

Abstract

PURPOSE
To evaluate the long-term surgical results of Ahmed glaucoma valve implantation (AGVI) and the effects of intracameral bevacizumab injection in neovascular glaucoma (NVG) after diabetic vitrectomy.
METHODS
We reviewed the medical records of 57 patients with NVG after diabetic vitrectomy who underwent AGVI with or without intracameral bevacizumab injection. In each group, preoperative and postoperative intraocular pressure, the number of glaucoma medications, and best corrected visual acuity (BCVA) were compared. We analyzed the rates of surgical success, postoperative complications, and risk factors.
RESULTS
The cumulative probability of success was 87.7% at 1 year, 78.8% at 2 years, 70.5% at 3 years, and 61.6% at 5 years. Intraocular pressure and the number of glaucoma medications were significantly reduced and BCVA was significantly better at all postoperative follow-up time points in both groups. There were no differences in mean intraocular pressure, the number of glaucoma medications, BCVA, or the rates of surgical success between the two groups. The incidence of hypertensive phase was significantly reduced in the intracameral bevacizumab group, but neither the surgical success rate nor intraocular pressures were different compared with the control group.
CONCLUSIONS
Ahmed glaucoma valve was a good therapeutic modality for long-term treatment of NVG occuring after diabetic vitrectomy. Intracameral bevacizumab injection had no effects on the surgical results of Ahmed glaucoma valve surgery.

Keyword

Ahmed glaucoma valve implantation; Bevacizumab; Diabetic vitrectomy; Neovascular glaucoma

MeSH Terms

Antibodies, Monoclonal, Humanized
Follow-Up Studies
Glaucoma
Glaucoma, Neovascular
Humans
Incidence
Intraocular Pressure
Medical Records
Postoperative Complications
Visual Acuity
Vitrectomy
Bevacizumab
Antibodies, Monoclonal, Humanized

Figure

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  Figure 1. Cumulative probability of the surgical success after Ahmed valve implantation for neovascular glaucoma after dia-betic vitrectomy. The figures under the horizontal axis indicate the number of patients that were followed up at that time.

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  Figure 2. Cumulative probability of the surgical success of the Avastin (Bevacizumab) group and the control group after Ahmed valve implantation for neovascular glaucoma after dia-betic vitrectomy. The figures under the horizontal axis indicate the number of patients that were followed up at that time (Avastin group/Control group). There was no statistically significant dif-ferences in success rate between the 2 groups ( p = 0.763).

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  Figure 3. Mean intraocular pressure changes of the Avastin group and the con-trol group after Ahmed valve implantation for neovascular glaucoma after diabetic vitrectomy. There was no statistically sig-nificant differences in the mean intraocular pressure between the 2 groups.

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  Figure 4. Mean number of glaucoma medi-cations of the Avastin group and the con-trol group after Ahmed valve implantation for neovascular glaucoma after diabetic vitrectomy. There was no statistically sig-nificant differences in the mean number of glaucoma medications between the 2 groups.

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  Figure 5. Mean best corrected visual acui-ty (log MAR) changes of the Avastin group and the control group after Ahmed valve implantation for neovascular glauco-ma after diabetic vitrectomy. There was no statistically significant differences in best corrected visual acuity between the 2 groups.

Reference

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