Comparision between Simultaneous Intracameral and Intravitreal Injection and Intravitreal Injection of Bevacizumab in Neovascular Glaucoma

ABSTRACT

PURPOSE: To compare the clinical efficacy of simultaneous intracameral and intravitreal injection and intravitreal single injection of bevacizumab in patients with neovascular glaucoma (NVG). METHODS: The medical records of 43 eyes of 43 patients, who had treated with simultaneous intracameral and intravitreal injection (Group I) or intravitreal single injection (Group II) of bevacizumab 1.25 mg from January 2010 to December 2012, were retrospectively reviewed. The best corrected visual acuity (BCVA), intraocular pressure (IOP), regression time of new vessel in the iris (NVI) and anterior chamber angle (NVA), progression of peripheral anterior synechiae (PAS), and corneal parameters were measured preoperatively and one day, three days, 1 week, 1 month, and 3 months postoperatively. RESULTS: There was significant changes of IOP between the two groups at 1, 3 days postoperatively (p = 0.001, p < 0.001). The regression time of NVI and NVA in Group I was significantly faster than Group II (p = 0.026, p = 0.033). In the phakic eyes, regression time of NVI and NVA was significantly longer than aphakic and pseudophakic eyes in group II (p = 0.006, p = 0.005). Also, in the phakic NVG patients, the formation of PAS in Group I was significantly less than in Group II for the postoperative three months (p = 0.020). CONCLUSIONS: Simultaneous intravitreal and intracameral injection of bevacizumab seem to be more effective for the early lowering of IOP and regression of NVI and NVA, and inhibiting further PAS formation in NVG patients, especially in the phakic eyes. Therefore, simultaneous intracameral and intravitreal injection of bevacizumab may be considered as an adjunct to management of NVG in the phakic eyes.