Avastin before glaucoma valve implantation may lead to less hyphema, fewer medications postop

Issue: August 25, 2015

A preoperative intravitreal bevacizumab injection before Ahmed glaucoma valve implantation may decrease postoperative hyphema and lower the number of glaucoma medications at last visit, according to a study.

The retrospective institutional study included patients with neovascular glaucoma who underwent Ahmed glaucoma valve (New World Medical) implantation, with 19 eyes receiving an intravitreal Avastin (bevacizumab, Genentech) injection 7 days preoperatively and 20 eyes receiving no anti-VEGF therapy.

The bevacizumab group had a significantly lower number of glaucoma medications, 0.74 ± 0.73, at the last visit compared with 1.30 ± 0.66 medications in the non-bevacizumab group. The bevacizumab group also had significantly less hyphema.

IOP improved from 41.41 ± 12.29 mm Hg preoperatively to 16.37 ± 5.72 mm Hg at the last follow-up visit in the bevacizumab group and from 44.55 ± 13.85 mm Hg to 20.05 ± 9.75 mm Hg in the non-bevacizumab group. The IOP reductions were statistically significant, but the differences between the two groups were not.

Best corrected visual acuity was 2.34 ± 1.00 in the bevacizumab group and 2.66 ± 1.04 in the non-bevacizumab group at the final follow-up. The difference was not statistically significant, but there was a significant deterioration of BCVA in the control group.

The probability of success was 63.2% in the bevacizumab group and 70% in the control group, which was not statistically significant. – by Kristie L. Kahl

Disclosure: The authors report no relevant financial disclosures.

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Source:

Sahyoun M, et al. J Glaucoma. 2015:doi:10.1097/IJG.0000000000000234.