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Y. Nakazawa, I. Kimura, A. Usui, M. Kiyokawa, O. Miyauchi, A. Mizota, M. Tanaka; Intravitreal Injection of Bevacizumab Treatment Does Not Improve the Long Term Efficacy of Intraocular Pressure Reduction After Trabeculectomy for Neovascular Glaucoma Derived From Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):593.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the effect of trabeculectomy with pretreatment of intravitreal injection of bevacizumab(IVB) as a treatment for neovascular glaucoma (NVG) derived from proliferative diabetic retinopathy(PDR).
Twenty two eyes in 20 cases(average age 55.3±14.6 years old) with NVG derived from PDR who had undergone trabeculectomy in Juntendo University Urayasu Hospital from 2005 were included in this study. Preoperative intraocular pressure(IOP) and visual acuity(VA), interventional therapy including surgical operation and IVB, change of IOP and visual acuity after operation, and complications during or after operation were reviewed retrospectively. All the cases had undergone trabeculectomy with mitomycin C.
The average follow-up period after surgery was 14.1±12.4 months and the average IOP before surgery was 24.7±16.1mmHg. All the cases had undergone vitrectomy(100%) before trabeculectomy, 6 eyes, cyclocryopexy (27.2%) and 10 eyes IVB(45.5%). The final average IOP was 15.7±9.8mmHg. Anti-glaucoma eye-drops was resumed for 12 eyes(54.5%) and oral carbonic anhydrase inhibitor had been started for the 4 cases(18.0%). The final VA for 6 eyes(27.3%) was under finger movement and 8 eyes(36.4%) exceeded 2/20, and 4 eyes(18.2%) did 10/20. The VA of 3 eyes(50%) out of 6 eyes in 4 cases under 40 years of age was under finger movement, whereas thw VA of 2 eyes(12.5%) out of 16 eyes in 16 cases forty and over was under finger movement. In IVB group(patients who had undergone IVB) and no-IVB group(patients who had not undergone IVB), the average IOP before surgery was 25.4±21.3 and 24.2±11.2mmHg respectively, and the final average IOP was 17.7±12.6 and 13.9±6.3mmHg respectively, and they showed no statistically significant difference between two groups(p>0.05)
There were many cases whose IOP control were difficult even after the trabeculectomy procedures for NVG derived from PDR. IVB treatment did not improve the long term efficacy of IOP reduction after trabeculectomy for NVG derived from PDR.
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