title: Adjunctive bevacizumab in patients undergoing Ahmed valve implantation: a pilot study.
abstract: OBJECTIVE
  To report on preliminary findings of adjunctive subconjunctival bevacizumab (SCB) injections in patients undergoing Ahmed valve implantation (AVI) (New World Medical, Rancho Cucamonga, CA).
  
  
  METHODS
  The study was approved by the institution's ethics committee. Patients were prospectively recruited during a 1-month period and randomized to receive AVI with postoperative SCB (days 1 and 7, n = 7) or AVI without SCB (n = 6).
  
  
  RESULTS
  Baseline intraocular pressure (IOP) in the treatment (AVI+SCB) group was 19.4 ± 8.6 mm Hg, whereas baseline IOP in the control (AVI) group was 32.1 ± 17.7 mm Hg (P = .119). Final IOP was 13.8 mm Hg (n = 7) for the treatment group and 12.7 mm Hg for the control group (n = 5, P = .790). One eye in the control group required further glaucoma intervention at day 45 and was considered a failure. The pre-massage postoperative IOP was significantly lower for the treatment group only at day 45 (16.1 vs 26.0 mm Hg, P = .012). Mean post-massage IOP was significantly lower in the treatment group at day 15 (11.28 vs 17.16 mm Hg, P = .004), day 30 (11.28 vs 20.83 mm Hg, P = .015), and day 45 (12.16 vs 21.33 mm Hg, P = .001), and similar at month 3. Mean change in bleb area was 11.4 mm(2) in the treatment group and -0.4 mm(2) in the control group (P = .036 and P = .361, respectively, Student's paired samples t test).
  
  
  CONCLUSIONS
  Bevacizumab was associated with a less aggressive hypertensive period as measured by post-massage IOP measurements, postoperative glaucoma medications, and cross-sectional bleb area by ultrasound. Further prospective studies are needed to better understand the utility of SCB at the time of AVI surgery.
authors.affiliation: Asociación Para Evitar la Ceguera en México, Coyoacán, Mexico.
authors.forename: María
authors.initials: M
authors.lastname: Rojo-Arnao
authors.forename: Oscar D
authors.initials: OD
authors.lastname: Albis-Donado
authors.forename: Manuel
authors.initials: M
authors.lastname: Lliteras-Cardin
authors.forename: Malik Y
authors.initials: MY
authors.lastname: Kahook
authors.forename: Félix
authors.initials: F
authors.lastname: Gil-Carrasco
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000959:Antihypertensive Agents / Q000008:administration & dosage; D000068258:Bevacizumab; D003228:Conjunctiva; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants / Q000009:adverse effects; D006801:Humans; D056965:Injections, Intraocular; D007429:Intraocular Pressure; D008297:Male; D008405:Massage; D008875:Middle Aged; D009798:Ocular Hypertension / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D010865:Pilot Projects; D011182:Postoperative Care; D011184:Postoperative Period; D011446:Prospective Studies; D014463:Ultrasonography
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000959:Antihypertensive Agents; D000068258:Bevacizumab