Concentration of Vascular Endothelial Growth Factor After Intracameral Bevacizumab Injection in Eyes With Neovascular Glaucoma

PURPOSE: To study the concentration of vascular endothelial growth factor (VEGF) in the aqueous humor before and after intracameral injection of bevacizumab in eyes with neovascular glaucoma, and to detect the duration of an anti-VEGF effect of bevacizumab in the anterior chamber. METHODS: In this prospective interventional case series, 1.25 mg of bevacizumab was injected into the anterior chamber of five eyes in five neovascular glaucoma patients. Aqueous humor samples were obtained just before intracameral injection of bevacizumab and two weeks after injection. The concentrations of VEGF in the aqueous humor were measured using ELISA. To investigate corneal endothelial damage after intrecameral bevacizumab injection, specular microscopy was performed before injection and two weeks after injection. Slit lamp photo and iris fluorescent angiography was performed to determine the regression of iris neovascularization. RESULTS: After injection, substantial regression of neovascularization or fluorescein leakage was seen in all treated eyes. The VEGF concentrations in the aqueous humor in eyes with NVG were 1181.8+/-1248.3 pg/mL before intracameral injection of bevacizumab. Two weeks after injection, the VEGF concentrations decreased to 33.2+/-12.2 pg/mL (p=0.04, Wilcoxon signed rank test). There were no significant changes in IOP or corneal endothelial cells. CONCLUSIONS: Intracameral bevacizumab injection can remarkably reduce iris neovascularization in neovascular glaucoma patients. VEGF levels were significantly decreased two weeks after injection and corneal toxicity was not observed during short term follow-up.

Bilateral Spontaneous Anterior Lens Dislocation in a Retinitis Pigmentosa Patient

PURPOSE: To report a case of bilateral spontaneous anterior lens dislocation associated with retinitis pigmentosa (RP). METHODS: A 45-year-old male with RP presented with elevated intraocular pressure (IOP) in the right eye and was treated with laser iridotomy (LI). After LI, complete crystalline lens dislocation into the anterior chamber occurred. Surgical intervention, including anterior vitrectomy, intracapsular cataract extraction (ICCE), and IOL scleral fixation was performed. Two years later, the same episode occurred in his left eye and a similar treatment was done. RESULTS: Surgery was successful in both eyes. CONCLUSIONS: This is the first report of bilateral spontaneous anterior lens dislocation in a RP patient.

Changes in Axial Length Following Trabeculectomy and Ahmed Glaucoma Valve Implantation

PURPOSE: This study examines the changes in axial length after trabeculectomy and Ahmed glaucoma valve implantation surgery. METHODS: In the forty three eyes of the 42 patients who had the uncontrolled glaucoma, 22 eyes of 21 patients having trabeculectomy and 21 eyes of 21 patients having Ahmed glaucoma valve implantation from October 2004 to September 2005 at Kim's Eye Hospital were analyzed prospectively. These patients had IOP and axial length measurements preoperatively, at 1 week, 1 month, and 3 months after surgery and refractive power measurements preoperatively, at 3 months after surgery. Axial length was measured by IOL Master(R). RESULTS: There was a statistically significant reduction in IOP after 3 months of 26.6+/-11.2 mmHg overall, 22.4+/-8.4 mmHg following trabeculectomy, and 30.9+/-12.3 mmHg after Ahmed glaucoma valve implatation (p<0.001). There was a statistically significant reduction in axial length after 3 months of -0.24+/-0.10 mm overall, -0.21+/-0.1 mm after trabeculectomy and -0.28+/-0.1 mm after Ahmed glaucoma valve implantation. CONCLUSIONS: There was a statistically significant decrease in axial length after both trabeculectomy and Ahmed glaucoma valve implantation. We must consider the influence of axial length change on refraction in planning combined glaucoma and cataract surgery or future IOL implantation.

The Effect of Involutional Entropion Surgery: Quickert-Rathbun Suture

PURPOSE: To evaluate the effectiveness of the Quickert-Rathbun suture to correct involutional entropion. METHODS: A retrospective review was performed of 132 consecutive patients (132 lids, male 58, female 74) with involutional entropion who underwent correction from September 2001 to June 2004 at Kim's eye hospital. All surgical corrections were performed with the Quickert-Rathbun suture technique. The average follow-up period was 9 months (1~17 months). RESULTS: The average length of follow-up time was 14 months (6~22 months). There were no long-term complications like lagophthalmos or ectropion. Surgery was successful in 102 (77.2%) of the 132 eyelids in the first Quickert-Rathbun suture. The second Quickert-Rathbun suture was performed to 17 out of 30 recurred patients, One of whom was noted to have recurrent entropion at 12 months. The final success rate of Quickert-Rathbun suture was 89.3%. The average length of recurrence time was 9.1+/-8.4 months. CONCLUSIONS: The Quickert-Rathbun suture described is simple, straightforward and reliable for the correction of involutional entropion primarily.