title: Evaluation of Ex-PRESS mini glaucoma shunt implantation with preoperative intracameral bevacizumab injection in refractory neovascular glaucoma.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of Ex-PRESS mini glaucoma shunt implantation with preoperative intracameral bevacizumab injection in eyes with refractory neovascular glaucoma.
  
  
  METHODS
  A retrospective chart review of patients with medically uncontrolled neovascular glaucoma who had received 50-µL intracameral bevacizumab (1.25 mg) before undergoing Ex-PRESS mini glaucoma shunt implantation was performed. Success was defined as a postoperative intraocular pressure (IOP) between 5 and 21 mm Hg without (complete success) or with or without (qualified success) glaucoma medications and no additional glaucoma surgery, or loss of light perception.
  
  
  RESULTS
  In total, 33 eyes of 33 patients (15 female, 18 male) were enrolled in the study. The mean age of the study population was 61.2 years (range 36-78). The mean IOP decreased from 41.0 mm Hg (range 24-72) to 17.6 mm Hg (range 8-28) over a mean follow-up of 20.9 months (range 6-60) (p&lt;0.001; Wilcoxon signed-rank test). Complete and qualified success rates were 36.4% and 66.7%, respectively. The average number of antiglaucoma medications decreased from 3.5 (range 2-4) preoperatively to 1.8 (range 1-4) postoperatively (p&lt;0.001; Wilcoxon signed rank test). In 81.8% of cases, the decrease in IOP was 30% or more postoperatively.
  
  
  CONCLUSIONS
  Ex-PRESS mini glaucoma shunt implantation with preoperative bevacizumab injection may be an effective alternative procedure for refractory neovascular glaucoma.
authors.affiliation: Faculty of Medicine, Department of Ophthalmology, Ege University, Izmir - Turkey.
authors.forename: Suzan
authors.initials: S
authors.lastname: Guven Yilmaz
authors.affiliation: Faculty of Medicine, Department of Ophthalmology, Ege University, Izmir - Turkey.
authors.forename: Seyda
authors.initials: S
authors.lastname: Yildirim
authors.affiliation: Faculty of Medicine, Department of Ophthalmology, Ege University, Izmir - Turkey.
authors.forename: Cumali
authors.initials: C
authors.lastname: Degirmenci
authors.affiliation: Faculty of Medicine, Department of Ophthalmology, Ege University, Izmir - Turkey.
authors.forename: Halil
authors.initials: H
authors.lastname: Ates
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000867:Anterior Chamber / Q000187:drug effects; D000068258:Bevacizumab / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D020327:Glaucoma Drainage Implants; D015355:Glaucoma, Neovascular / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D056965:Injections, Intraocular; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab