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Jocelyn Lam, Ian Luttrell, Kasra Rezaei, Jennifer R Chao, Yewlin Chee, Leona Ding, Joanne C Wen; Effect of glaucoma surgery on post-injection IOP elevation in patients undergoing intravitreal anti-VEGF injections. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2689.
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To characterize how incisional glaucoma surgery affects the intraocular pressure (IOP) elevation following intravitreal anti-VEGF injections.
Patients receiving intravitreal anti-VEGF injections with a history of incisional glaucoma surgery (trabeculectomy or glaucoma drainage device) were recruited. Control eyes that did not have a history of incisional glaucoma surgery were also recruited. Pre and post-injection IOP values were measured at 1-5 minute intervals following intravitreal injection. Pre and post-injection IOP values were compared among control and glaucoma surgery eyes.
Four eyes with a history of glaucoma surgery and 23 control eyes were recruited. Mean age of patients with glaucoma surgery eyes was 70.2 ± 17.7 years and control eyes was 64.1 ± 12.4 years (p=0.2). In the glaucoma surgery eyes, the most common indication for intravitreal anti-VEGF injection was vein occlusion (50%) while diabetic macular edema was the most common indication for control eyes (53%). Indications for glaucoma surgery included primary open angle glaucoma (3/4) and neovascular glaucoma (1/4). Post-injection IOP was significantly increased compared to baseline IOP after anti-VEGF injection in control eyes (mean change in IOP = 28.2 ± 9.6 mmHg; p<0.001) and in glaucoma surgery eyes (mean change in IOP = 13.1 ± 6.7 mmHg; p=0.03). The mean change in IOP following intravitreal anti-VEGF injection in glaucoma surgery eyes was significantly less than in control eyes (p=0.006, unpaired t-test). The mean time for the IOP to return to within 10 mmHg of pre-injection IOP was less in glaucoma surgery eyes (6.1 ± 5.4 mins) than in control eyes (13.4 ± 8.2 mins) but did not reach statistical significance (p=0.09).
Although intravitreal anti-VEGF injections lead to a significant rise in IOP in eyes with or without glaucoma surgery, glaucoma surgery eyes had significantly less post-injection IOP elevation compared to control eyes.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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