Long-Term Results of Ahmed Valve Implantation in Neovascular Glaucoma and the Effects of Intracameral Bevacizumab

ABSTRACT

PURPOSE: To evaluate the long-term surgical results of Ahmed glaucoma valve implantation (AGVI) and the effects of intracameral bevacizumab injection in neovascular glaucoma (NVG) after diabetic vitrectomy. METHODS: We reviewed the medical records of 57 patients with NVG after diabetic vitrectomy who underwent AGVI with or without intracameral bevacizumab injection. In each group, preoperative and postoperative intraocular pressure, the number of glaucoma medications, and best corrected visual acuity (BCVA) were compared. We analyzed the rates of surgical success, postoperative complications, and risk factors. RESULTS: The cumulative probability of success was 87.7% at 1 year, 78.8% at 2 years, 70.5% at 3 years, and 61.6% at 5 years. Intraocular pressure and the number of glaucoma medications were significantly reduced and BCVA was significantly better at all postoperative follow-up time points in both groups. There were no differences in mean intraocular pressure, the number of glaucoma medications, BCVA, or the rates of surgical success between the two groups. The incidence of hypertensive phase was significantly reduced in the intracameral bevacizumab group, but neither the surgical success rate nor intraocular pressures were different compared with the control group. CONCLUSIONS: Ahmed glaucoma valve was a good therapeutic modality for long-term treatment of NVG occuring after diabetic vitrectomy. Intracameral bevacizumab injection had no effects on the surgical results of Ahmed glaucoma valve surgery.