title: Surgical results of Ahmed valve implantation with intraoperative bevacizumab injection in patients with neovascular glaucoma.
abstract: OBJECTIVE
  To investigate the surgical results of Ahmed valve implantation with intraoperative bevacizumab injection in patients with neovascular glaucoma (NVG).
  
  
  METHODS
  A retrospective comparative case series review was conducted on 52 eyes with NVG who underwent Ahmed glaucoma valve implantation with or without intraoperative bevacizumab intravitreal injection. In the intraoperative intravitreous bevacizumab injection group (IVB group, 20 eyes), 1.25 mg of bevacizumab was injected into the vitreous cavity during Ahmed valve implantation. In the control group (32 eyes), only Ahmed valve implantation was performed. Surgical failure was defined when (1) the postoperative intraocular pressure was over 21 mm Hg at consecutive clinic visits, (2) the visual acuity became light perception negative, (3) additional antiglaucomatic surgery was required, or (4) devastating operative or postoperative complications were noted.
  
  
  RESULTS
  Although the success rate in the IVB group (70.0%) was higher than that in the control group (62.5%) 1 year after operation, the differences were not statistically significant (P=0.828 by log-rank test). Mean intraocular pressures in the IVB group were significantly lower than those of the control group at 12 and 15 months (P<0.05 by the Mann-Whitney U test). Postoperative complications were similar between the 2 groups. Preoperative history of trabeculectomy was a significant risk factor for surgical failure of Ahmed valve implantation in NVG (relative risk=4.618; P=0.018 by Cox regression model).
  
  
  CONCLUSIONS
  Intraoperative IVB injection does not seem to be helpful for better surgical outcomes of Ahmed valve implantation in NVG. A history of trabeculectomy is a risk factor for failure after Ahmed valve implantation in patients with NVG.
authors.affiliation: Siloam Eye Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kyoung Tak
authors.initials: KT
authors.lastname: Ma
authors.forename: Jong Yun
authors.initials: JY
authors.lastname: Yang
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Na Rae
authors.initials: NR
authors.lastname: Kim
authors.forename: Samin
authors.initials: S
authors.lastname: Hong
authors.forename: Eun Suk
authors.initials: ES
authors.lastname: Lee
authors.forename: Gong Je
authors.initials: GJ
authors.lastname: Seong
authors.forename: Chan Yun
authors.initials: CY
authors.lastname: Kim
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D003131:Combined Modality Therapy; D005260:Female; D020327:Glaucoma Drainage Implants; D015355:Glaucoma, Neovascular / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007430:Intraoperative Care; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab