Intravitreal ranibizumab injection combined trabeculectomy versus Ahmed glaucoma valve implantation in the treatment of neovascular glaucoma

ABSTRACT

Objective To evaluate and compare the efficacy and safety of intravitreal ranibizumab injection combined trabeculectomy and intravitreal ranibizumab injection combined Ahmed glaucoma valve implantation in the treatment of neovascular glaucoma (NVG).Methods A retrospective case-control study was designed.The clinical data of seventy-six eyes of seventy-six patients with NVG who received intravitreal ranibizumab injection combined trabeculectomy or Ahmed glaucoma valve implantation were collected in Jingmen NO.2 People's Hospital between May 2013 to May 2015.The eyes were divided into two groups according to different surgical

methods:

intravitreal ranibizumab injection combined trabeculectomy group (40 patients 40 eyes) and intravitreal ranibizumab injection combined Ahmed glaucoma valve implantation group (36 patients 36 eyes).The surgical success rate,intraocular pressure (IOP),number of antiglaucoma medications used,best correct visual acuity and postoperative complications were analyzed between the two groups.Results Compared with preoperative IOP,the postoperative IOPs in the two groups were all significantly decreased,with significant differences between them (P＜0.001).The postoperative IOP,mean number of postoperative antiglaucoma medications,and best correct visual acuity were not significant different between the two groups at all follow-up intervals.Kaplan-Meier survival curves showed that,the successful rate was 57.5％ for the ranibizumab injection combined trabeculectomy group and 72.2％ for the ranibizumab injection combined Ahmed glaucoma valve implantation group at follow-up endpoint,with no significant difference between the two groups (P =0.287).No statistically significant differences were found between the two groups when the complication rates were compared (P ＞ 0.05).Conclusions Intravitreal ranibizumab injection combined trabeculectomy and intravitreal ranibizumab injection combined Ahmed glaucoma valve implantation are both the effective method in managing NVG.The two different methods have a similar efficacy.