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Joao Nassaralla, João Nassaralla, Belquiz Nassaralla; Intravitreal Bevacizumab or Ranibizumab for Rubeosis Iridis - 3 years follow up. Invest. Ophthalmol. Vis. Sci. 2013;54(15):444.
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To determine and compare whether intraocular bevacizumab and ranibzumab decreases RI in patients with neovascular glaucoma (NVG).
The study included 72 eyes of 64 patients with secondary NVG due to proliferative diabetic retinopathy (n=60) or ischemic vessel occlusion (n=12). All patients received an intraocular injection (IOI) of 1.25 mg of bevacizumab (IB) or ranibizumab (IR), from November 2007 to October 2012 at the Goiania Eye Institute. Intraocular injection was performed in topical anaesthesia either in the anterior chamber (n=58) or via pars plana intravitreally (n=14). RI was investigated prospectively by iris biomicroscopy. An expanded informed consent with an off-label use waiver and explanation letter was reviewed with all patients. The IOI was performed under sterile conditions in an operating theatre and was performed with proximetacaine (Anestalcon® - Alcon - Brazil) topical anesthesia and the injection did via pars plana. The follow up
Degree of RI decreased significantly (p<0.01) within 1 week after application of both drus. The improvement was maintained for at least 4 weeks when was did PRP. After 3 years only 5 eyes (3 IB and 2 IR) development reccurent RI, when was did more injection and more PRP. The two drugs are about equal in their effectiveness. An inflammatory response with fibrinous reaction and pseudohypopyon was observed in three cases (2 bevacizumab and 1 with ranibizumab) one day after surgery. The reaction persisted only 2 days. However, that cost differences for those receiving treatment are major at about $40 per injection for Avastin and $2,000 per injection for Lucentis.
The preliminary conclusion is that the two drugs are about equal in their effectiveness.
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