Efficacy of intravitreal bevacizumab with panretinal photocoagulation followed by Ahmed valve implantation in neovascular glaucoma

Abstract

Purpose: To establish the efficacy and safety of intravitreal bevacizumab (Avastin) with panretinal photocoagulation (PRP) followed by Ahmed valve implantation in the treatment of neovascular glaucoma (NVG).

Method: This prospective randomized study included 40 eyes of 40 patients with refractory NVG. Twenty eyes underwent Ahmed valve implantation with intravitreal bevacizumab (Avastin) (1.25 mg in 0.5 mL) and PRP and 20 eyes were managed by Ahmed valve and PRP (control group). The follow-up period was 18 months.

Results: Complete success was defined as an intraocular pressure ≤ 21 mm Hg. Qualified success was considered when the above criteria were fulfilled but with additions of antiglaucoma topical medical treatment. The results revealed 95% total success (75% complete success and 20% qualified success) in the first group in which Avastin-augmented Ahmed valve was performed compared with 50% total success in the control group in which Ahmed valve implantation was performed alone (25% complete success and 25% qualified success).

Conclusions: Intravitreal bevacizumab (Avastin) with PRP followed by Ahmed valve implantation appears to be effective in the management of NVG.