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E. S. Arcieri, D. J. L. Secches, J. S. Paula, K. A. Barella, R. S. Arcieri, R. Jorge, V. P. Costa; Efficacy and Safety of Intravitreal Bevacizumab in Eyes With Neovascular Glaucoma Undergoing Ahmed Glaucoma Valve Implantation - Preliminary Report. Invest. Ophthalmol. Vis. Sci. 2010;51(13):627.
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To evaluate the safety and efficacy of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing Ahmed Glaucoma Valve implantation.
Multicenter, prospective, randomized clinical trial that enrolled 29 patients from 3 centers. All patients with uncontrolled neovascular glaucoma that had undergone panretinal photocoagulation and required glaucoma drainage device implantation were eligible. Patients were randomized to receive intravitreal injections of bevacizumab (1.25mg) or not during Ahmed Valve implant surgery. Injections were performed intraoperatively, and 4 and 8 weeks after surgery.
The preoperative data were similar between groups. After a mean follow-up of 7.96 ± 3.95 months, both groups showed a similar decrease in IOP (50.7% in the bevacizumab group and 61.5% in the control group, p=0.7750). Postoperatively, there were no significant differences in visual acuity (p>0.1270), mean number of antiglaucoma medications (p>0.3112), and extension of goniosynechiae (p>0.0685) between the groups. At the end of follow-up, the decrease in the extension of new vessels in the anterior chamber angle in the bevacizumab group was significantly higher than in the control group (p=0.0051). Although both groups showed a significant decrease in the extension of rubeosis iridis at the end of follow-up (p<0.05), complete regression of rubeosis iridis was significantly more frequent in the bevacizumab group (92.3%) than in the control group (25%) (p=0.0011).
Bevacizumab may lead to regression of new vessels both in the iris and the anterior chamber angle in patients with neovascular glaucoma undergoing Ahmed Glaucoma Valve implantation. Nevertheless, these findings were not associated with better IOP control after a short term follow-up.
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