Effect on anterior chamber bevacizumab injection combined with seton implantation in treatment of rubeosis iridis in Neovascular Glaucoma

• Published in: Cutaneous and ocular toxicology 2012-06, Vol.31 (2), p.124-127
• Main Authors: Kocak Altintas, Ayse Gul, Arifoglu, Hasan Basri, Tutar, Esen, Koklu, Gultekin, Ozcan, Pehmen Yasin
• Format: Article
• Language: English
• Subjects: Adult; Aged; Angiogenesis Inhibitors - administration & dosage; Anterior Chamber; Antibodies, Monoclonal, Humanized - administration & dosage; Bevacizumab; Female; glaucoma drainage devices; Glaucoma, Neovascular - drug therapy; Humans; Injections; Iris neovascularization; Iritis - drug therapy; Male; Middle Aged; neovascular glaucoma; Suture Techniques
• ISSN: 1556-9527; 1556-9535
• DOI: 10.3109/15569527.2011.621917

Objective: To evaluate the effect of anti-VEGF (bevacizumab) injection to the posterior chamber (BIPC) behind the iris combined with seton implantation in treatment of neovascular glaucoma (NVG). Methods: Twenty-eight eyes with NVG who underwent BIPC, prospectively evaluated. Anterior segment photographs were taken for grading of neovascularization on anterior segment in pretreatment period and at each follow-up. Grading and regression of rubeosis iridis was classified according to Teich and Walsh grading system and glaucoma filtration surgery with drainage device was performed following BIPC. Results: The mean pre-BIPC IOP was 39.71 ± 7.09 mmHg, post-BIPC IOP in the 1st, 2nd day, 1st week, 1st, 3rd, 6th month were 19.7 ± 8.9 mmHg, 13.5 ± 6.7 mmHg, 9.9 ± 3.4 mmHg, 13.07 ± 5.3 mmHg, 16.6 ± 5.03 mmHg, 18.5 ± 3.8 mmHg, respectively. Twenty seven eyes underwent seton implantation surgery. No one had anterior segment bleeding during surgery. The pre-BIPC grades were Grade 4: 67.58%, Grade 3: 28.57%, Grade 2: 3.57%, no one had Grade 1or Grade 0, while post BIPC grade were at the 1st week Grade 1: 64.28%, Grade 0: 35.71%, no one had Grade 2 or more, at 1st month Grade 2: 3.57%, Grade 1: 39.28%, Grade 0: 57.14%, at 3rd month Grade 2: 17.85% Grade 1: 28.57%, Grade 0: 53.57%, no one had Grade 3 or more both in first and the third month, at 6th month Grade 3: 7.14%, Grade 2: 28.57%, Grade 1: 42.85%, Grade 0: 21.42%. and no one had Grade 4. Conclusion: Significant reduction of NV was observed during the first week. Minimal increasement was seen in third month, significant regression effect persisted for 6 months. BIPC inhibited the peroperative risk of anterior segment bleeding, increased the surgical comfort and prevented the failure of filtration procedure by inhibiting reproliferation.