Purchase this article with an account.
Rajen U. Desai, Kuldev Singh, Shan C. Lin; Intravitreal Ranibizumab an Adjunct for Ahmed Valve Surgery in Open Angle Glaucoma: A Pilot Study. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3746.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To determine the safety and efficacy of intravitreal ranibizumab therapy before and after Ahmed tube insertion for open angle glaucoma (OAG) as a means of achieving better postoperative intraocular pressure (IOP) control.
Open angle glaucoma patients scheduled for Ahmed valve surgery, with or without combined phacoemulsification cataract surgery, were randomized to either ranibizumab or control groups. Ranibizumab (0.5 mg in 0.05 ml) was administered intravitreally at 3 time points: 9 days prior to surgery, 1 month post-surgery, and 2 months post-surgery. Patients in the control group underwent the same procedure without ranibizumab. Success at 6 months postoperatively was defined as IOP < 18 mmHg with no adjunctive medications, or IOP < 15 mmHg with one adjunctive medication.
The study and control arms included 6 and 5 subjects, respectively, with 4 in each arm undergoing combined cataract surgery. In the ranibizumab arm, the pre- and postoperative IOP/medication usage was 21.0 ± 6.7 mmHg on 3.2 ± 1.5 medications and 14.7 ± 1.9 mmHg on 0.5 ± 0.8 medications, respectively. In the control arm, the pre- and postoperative IOP/medication usage was 18.8 ± 3.8 mmHg on 2.8 ± 1.3 medications and 16.2 ± 3.6 mmHg with 1.8 ± 1.6 medications, respectively. Success was achieved in 83% of subjects in the ranibizumab group compared to 40% in the control group (2-tailed Fisher’s exact test, p = 0.24).
The findings from this small pilot comparative study suggest that intravitreal ranibizumab use may be a safe and potentially effective adjunctive treatment modality in improving success after Ahmed tube placement.
This PDF is available to Subscribers Only