May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Effect of Needle Bleb Revision With Ranibizumab as a Primary Intervention in a Failing Bleb Following Trabeculectomy
Author Affiliations & Notes
  • J. M. Purcell
    Ophthalmology, New York Eye and Ear Infirmary, New York, New York
  • C. C. Teng
    Ophthalmology, New York University Medical Center, New York, New York
    Ophthalmology, Manhattan Eye, Ear and Throat Hospital, New York, New York
  • C. Tello
    Ophthalmology, New York Eye and Ear Infirmary, New York, New York
  • J. M. Liebmann
    Ophthalmology, New York University Medical Center, New York, New York
    Ophthalmology, Manhattan Eye, Ear and Throat Hospital, New York, New York
  • R. Ritch
    Ophthalmology, New York Eye and Ear Infirmary, New York, New York
  • Footnotes
    Commercial Relationships  J.M. Purcell, None; C.C. Teng, None; C. Tello, None; J.M. Liebmann, None; R. Ritch, None.
  • Footnotes
    Support  Genentech Research Grant, San Francisco, CA. The Chiharu and Shigeru Handa Research Fund and the Janet Ruttenberg Research Fund of the New York Glaucoma Research Institute, New York, NY.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 4165. doi:https://doi.org/
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      J. M. Purcell, C. C. Teng, C. Tello, J. M. Liebmann, R. Ritch; Effect of Needle Bleb Revision With Ranibizumab as a Primary Intervention in a Failing Bleb Following Trabeculectomy. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4165. doi: https://doi.org/.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose: : To evaluate the effect of needle bleb revision with ranibizumab as a primary intervention in patients with a failing bleb following trabeculectomy.

Methods: : 6 patients were enrolled in this prospective study. All patients had prior trabeculectomy for open angle glaucoma and were deemed to have a failing trabeculectomy requiring needling. Baseline IOP was measured and bleb morphology was characterized. Bleb description was based on vascularity, elevation and number of cysts, graded on a scale of 0 to 4 (0= no change, 1= minimal, 2= mild, 3= moderate, 4= diffuse). Patients were then needled and injected with subconjunctival ranibizumab 0.5 mg (0.05 mL). IOP and bleb characteristics were then assessed for any changes at 1 week and 1 month intervals. The measurements were compared by paired t-test.

Results: : 6 eyes of 6 patients (3 females, 3 males), mean age 71 ± 7.3 years were enrolled. Mean pre-injection IOP was 27.2 ± 6.4, bleb vascularity 3.3 ± 0.8, bleb elevation 2.3 ± 0.8, bleb cysts 0.8 ± 1.7. At one week, IOP decreased to 14.6 ± 8.3 (p<0.007) and bleb vascularity decreased to 2.3 ± 1.0 (p<0.04). Change in bleb elevation (p<0.39) and bleb cysts (p<0.13) were insignificant. At one month after injection, IOP and vascularity remained decreased. Mean IOP was 14.5 ± 4.9 (p<0.002) and bleb vascularity 1.5 ± 0.8 (p<0.002). There was no statistical difference in elevation (p<0.18) or cysts (p<0.11).

Conclusions: : Adjunctive subconjunctival ranibizumab with needling was well tolerated and decreased IOP and vascularity of blebs at 1 week and 1 month follow up. Reduction in bleb vascularity suggests that anti-VEGF therapy may have a role in the treatment of failing bleb following trabeculectomy. Further studies exploring treatment intervals and applications are warranted.

Clinical Trial: : www.clinicaltrials.gov 07.10

Keywords: aqueous • drug toxicity/drug effects • injection 
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×