title: Efficacy and safety of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing Ahmed glaucoma valve implantation: 2-year follow-up.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of intravitreal bevacizumab (IVB) in eyes with neovascular glaucoma (NVG) undergoing Ahmed glaucoma valve (AGV) implantation.
  
  
  METHODS
  This 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 receive IVB (1.25 mg) or not during Ahmed valve implant surgery. Injections were administered intra-operatively, and 4 and 8 weeks after surgery.
  
  
  RESULTS
  After a mean follow-up of 2.25 ± 0.67 years (range 1.5-3 years), both groups showed a significant decrease in IOP (p < 0.05). There was no difference in IOP between groups except at the 18-month interval, when IOP in IVB group 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 with IVB using less antiglaucoma medications than the control group (p = 0.0648). Complete regression of rubeosis iridis was significantly more frequent in the IVB group (80%) than in the control group (25%) (p = 0.0015).
  
  
  CONCLUSIONS
  Intravitreal 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 lower IOPs and number of medications with IVB use during AGV implantation for neovascular glaucoma.
authors.affiliation: Department of Ophthalmology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil; Department of Ophthalmology, Presidente Antônio Carlos University (UNIPAC), Araguari, Minas Gerais, Brazil; Department of Ophthalmology, Federal University of Uberlândia (UFU), Uberlândia, Minas Gerais, Brazil.
authors.forename: Enyr S
authors.initials: ES
authors.lastname: Arcieri
authors.forename: Jayter S
authors.initials: JS
authors.lastname: Paula
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jorge
authors.forename: Kleyton A
authors.initials: KA
authors.lastname: Barella
authors.forename: Rafael S
authors.initials: RS
authors.lastname: Arcieri
authors.forename: Danilo J
authors.initials: DJ
authors.lastname: Secches
authors.forename: Vital P
authors.initials: VP
authors.lastname: Costa
mesh_terms: D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000867:Anterior Chamber / Q000098:blood supply; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D000068258:Bevacizumab; D005260:Female; D005500:Follow-Up Studies; D020327:Glaucoma Drainage Implants; D015355:Glaucoma, Neovascular / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D058449:Intravitreal Injections; D007498:Iris / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019919:Prosthesis Implantation; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab
keywords: bevacizumab; glaucoma; glaucoma drainage implants; intraocular pressure; neovascular