Intravitreal Bevacizumab and Subsequent Trabeculectomy with Mitomycin C for Neovascular Glaucoma with Previous Sutureless Vitrectomy.
10.3341/jkos.2016.57.4.607
- Author:
Keun Heung PARK
1
;
Hyo Chul LIM
;
Ji Woong LEE
Author Information
1. Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea. alertlee@naver.com
- Publication Type:Original Article
- Keywords:
Intravitreal bevacizumab injection;
Neovascular glaucoma;
Trabeculectomy with mitomycin C;
Transconjuctival sutureless vitrectomy
- MeSH:
Glaucoma;
Glaucoma, Neovascular*;
Humans;
Intraocular Pressure;
Medical Records;
Mitomycin*;
Outcome Assessment (Health Care);
Retrospective Studies;
Trabeculectomy*;
Visual Acuity;
Vitrectomy*
- From:Journal of the Korean Ophthalmological Society
2016;57(4):607-613
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To evaluate the efficacy of intravitreal bevacizumab and subsequent trabeculectomy with mitomycin C (MMC) for neovascular glaucoma (NVG) in eyes that underwent previous 23-gauge transconjunctival sutureless vitrectomy (TSV). METHODS: This was a retrospective, comparative, and consecutive case series study. We reviewed the medical records of patients with NVG who underwent trabeculectomy with MMC after intravitreal bevacizumab (1.25 mg/0.05 mL) injection and compared the surgical outcomes according to 23-gauge TSV history. Surgical success was defined as an intraocular pressure (IOP) of ≥6 mm Hg and ≤21 mm Hg without additional glaucoma surgery or loss of light perception. The main outcome measures were postoperative IOP control, visual acuity, and complications. RESULTS: A total of 27 patients (27 eyes) were included; 12 patients with 23-gauge TSV history (TSV group) and 15 patients without vitrectomy history (nonvitrectomized group). The cumulative probability of success after trabeculectomy with MMC was 82.5% and 73.3% after one year for the TSV group and the nonvitrectomized group, respectively (p = 0.523). Mean IOP decreased from 37.3 ± 9.0 mm Hg preoperatively to 12.8 ± 6.2 mmHg at the final visit in the TSV group (p = 0.002). Mean IOP decreased from 40.3 ± 9.7 mm Hg preoperatively to 17.8 ± 11.7 mm Hg at the final visit in the nonvitrectomized group (p = 0.001). Preoperative and final IOP were not significantly different between the two groups. Complications were comparable between the groups. CONCLUSIONS: Intravitreal bevacizumab injection and subsequent trabeculectomy with MMC is an effective method for controlling IOP in patients with NVG associated with sutureless vitrectomy.
