Efficacy and safety of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing ahmed glaucoma valve implantation: 2‐year follow‐up

AbstractPurposeTo evaluate the efficacy and safety of intravitreal bevacizumab (IVB) in eyes with neovascular glaucoma (NVG) undergoing Ahmed glaucoma valve (AGV) implantation.MethodsThis was a multicentre, prospective, randomized clinical trial that enrolled 40 patients with uncontrolled neovascular glaucoma that had undergone panretinal photocoagulation and required glaucoma drainage device implantation. Patients were randomized to receiveIVB(1.25 mg) or not during Ahmed valve implant surgery. Injections were administered intra‐operatively, and 4 and 8 weeks after surgery.ResultsAfter a mean follow‐up of 2.25 ± 0.67 years (range 1.5–3 years), both groups showed a significant decrease inIOP(p < 0.05). There was no difference inIOPbetween groups except at the 18‐month interval, whenIOPinIVBgroup was significantly lower (14.57 ± 1.72 mmHg vs. 18.37 ± 1.06 mmHg – p = 0.0002). There was no difference in survival success rates between groups. At 24 months, there was a trend to patients treated withIVBusing less antiglaucoma medications than the control group (p = 0.0648). Complete regression of rubeosis iridis was significantly more frequent in theIVBgroup (80%) than in the control group (25%) (p = 0.0015).ConclusionsIntravitreal bevacizumab may lead to regression of new vessels both in the iris and in the anterior chamber angle in patients with neovascular glaucoma undergoing Ahmed glaucoma valve implantation. There is a trend to slightly lowerIOPs and number of medications withIVBuse duringAGVimplantation for neovascular glaucoma.