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Youhyun Lee, Kwang-Soo Kim, Sungdong Chang; The Effect of Intravitreal Bevacizumab Injection before Trabeculectomy in Patients with Neovascular Glaucoma. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2726.
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To evaluate the efficacy of preoperative intravitreal bevacizumab injection (IVB) and prognostic factors of surgical success in neovascular glaucoma patients, who underwent trabeculectomy.
A total of 58 patients(58 eyes) diagnosed with neovascular glaucoma and underwent trabeculectomy between 2003 and 2013 were enrolled in this retrospective study. To evaluate the efficacy of preoperative IVB, the patients were divided into preoperative IVB group and trabeculectomy only group. Best corrected visual acuity (BCVA) and intraocular pressure (IOP) was measured from preoperative to postoperative 12 months. To evaluate the prognostic factors related to surgical success, the following was investigated: age, lens status, preoperative IVB, time interval between preoperative IVB and trabeculectomy, whether trabeculectomy was done after the regression of neovascularization of iris, previous vitrectomy, and postoperative hyphema.
All 58 eyes had panretinal photocoagulation before trabeculecotmy. Among these, preoperative IVB was done in 32 eyes. Preoperative IVB group showed longer period of retaining surgical success status by Kaplan Meier survival analysis and statistically significant IOP reduction effect (p = 0.048) and lesser numbers of anti-glaucoma medication prescription (p = 0.040) by Mann-whitney U-test. Postoperative hyphema was mentioned as risk factors for surgical failure in univariate analysis (p = 0.044), however, only preoperative IVB was protective factor in multivariate analysis (p = 0.046).
In neovascular glaucoma patients, preoperative IVB before trabeculectomy is a good prognostic factor of surgical success and shows benefit in lowering the IOP and reducing the numbers of anti-glaucoma medication prescription at postoperative one year.
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