Abstract
Purpose :
To assess the data of all patients from one Glaucoma specialist who underwent Glaucoma Surgery in Vancouver between 2016 and 2017 and relate it to anti-VEGF intravitreal injections.
Methods :
A retrospective medical chart review is being conducted to analyze the information from all the patients who underwent Glaucoma Surgery in the period from January 2016 to December 2017, with one of the attending doctors at the main Glaucoma reference center in Vancouver, British Columbia. All patients who were having intravitreal treatment with anti-VEGF medication at the time they needed Surgery to control the intraocular pressure are being included. We excluded those patients who had intravitreal injections with steroid medication and the patients who developed neovascular glaucoma.
Results :
As the study is not yet finalized, the numbers and the information gathered from the study will be updated by the time of presentation. At this time, in a period of 4 months, 57 Glaucoma surgeries have been performed (40 Trabeculectomies or Combined Trabeculectomies with Cataract Extraction, 2 Deep Sclerectomies, 20 Tube Shunt devices, 1 Cataract extraction combined with i-Stent device, 5 Xen gel stent devices). From this total, 22 patients were regularly having intravitreal injections. Three of these 22 patients had Neovascular Glaucoma and therefore, will be excluded from the study. Thirteen patients were being treated for Age-related Macular Degeneration, two had central or branch vein occlusion, three had Diabetic Retinopathy and 1 presented with idiopathic retinal ischemia. Visual acuity before and after Surgery, as well as IOP and number of drops needed for IOP control before and after surgery will also be evaluated.
Conclusions :
At the moment, from our partial data, one third of the patients who needed Glaucoma Surgery for Intraocular Pressure (IOP) control were being treated with intravitreal Anti-VEGF injections. This rate of Glaucoma Surgery among patients that need anti vascular endothelial growth factor has never been previously reported in the literature worldwide. The relationship between the number of injections and the IOP elevation, the pre-existing risk factors for developing Glaucoma before starting anti-VEGF protocols as well as the compounding process and medication storage should be debated. The impact of such high rate of Glaucoma Surgeries for the Health System still need to be better analyzed.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.