Management of neovascular glaucoma with transscleral cyclophotocoagulation with diode laser alone versus combination transscleral cyclophotocoagulation with diode laser and intravitreal bevacizumab.
BACKGROUND
Trans-scleral cyclophotocoagulation with diode laser has been well documented in the management of neovascular glaucoma. More recently, intravitreal bevacizumab has been increasingly employed to treat neovascular diseases of the eye. This study reports our initial experience with trans-scleral cyclophotocoagulation alone versus the combination of trans-scleral cyclophotocoagulation and intravitreal bevacizumab for management of neovascular glaucoma.


METHODS
Retrospective uncontrolled comparative case series


METHODS
A total of 31 eyes of 30 consecutive patients were included - 11 eyes in the trans-scleral cyclophotocoagulation alone group and 20 in the combination trans-scleral cyclophotocoagulation and intravitreal bevacizumab group.


METHODS
The records of all patients diagnosed with neovascular glaucoma undergoing trans-scleral cyclophotocoagulation with or without intravitreal bevacizumab performed by a single ophthalmic surgeon in a glaucoma specialist centre were reviewed.


METHODS
Data collected included intraocular pressure, anterior segment neovascularisation, best-corrected visual acuity, use of medications and complications.


RESULTS
Mean reduction in intraocular pressure was 33.5 mmHg in the trans-scleral cyclophotocoagulation group and 23.7 mmHg in the combination group, a difference of 9.8 mmHg (95% CI -1.5, 21.1). Complications included hypotony in three (27%) eyes in the trans-scleral cyclophotocoagulation group and two (10%) eyes in the combination group. Three eyes required evisceration.


CONCLUSIONS
Trans-scleral cyclophotocoagulation alone is effective in lowering intraocular pressure in neovascular glaucoma. In this study, the addition of intravitreal bevacizumab to trans-scleral cyclophotocoagulation did not statistically advantage treatment outcomes.
City Eye Centre, Brisbane, Queensland, Australia.
Anthony W
AW
Fong
Graham A
GA
Lee
Peter
P
O'Rourke
Ravi
R
Thomas
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D002924:Ciliary Body / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D015355:Glaucoma, Neovascular / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D058449:Intravitreal Injections; D017075:Laser Coagulation; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab