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Ahmed glaucoma valve implantation with and without subconjunctival bevacizumab in refractory glaucoma

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Abstract

Purpose

To evaluate the effects of subconjunctival bevacizumab injection on intraocular pressure (IOP), hypertensive phase, and failure and success rates of Ahmed Glaucoma Valve (AGV) implantation.

Methods

A total of 63 eyes of 63 patients (30 cases in control and 33 cases in bevacizumab group) were included in this randomized masked prospective clinical trial. Pre- and postoperative BCVA, IOP, number of medications, complications and success rates were compared between

AGV + bevacizumab and AGV alone group.

Results

Both groups showed statistically significant reductions in IOP in all their follow-up visits (P < 0.05). The mean IOP was lower in the AGV + Bevacizumab group than AGV group in all follow-up visits. However, the difference was only significant at the 3rd month (17.3 ± 6.2 vs. 20.7 ± 4.6, p = 0.04). The number of medications was not differed significantly between the two groups at their last visit (p value = 0.84) Complete success rate was higher in AGV + Bevacizumab. However, the difference was not significant (p = 0.73). The qualified and overall success rate, failure rate and the need for second tube were not statistically different between the two groups. The hypertensive phase was not statistically significant between the 2 groups (33.3% in AGV + Bevacizumab group and 50% in AGV group, p = 0.06)

Conclusion

Adjunctive use of Bevacizumab during AGV implantation is beneficial in controlling hypertensive phase and IOP control and may lead to higher success rates and lower failure rates after AGV implantation. However, whether it’s clearly beneficial or its exact role remains to be investigated.

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Authors and Affiliations

  1. Farabi Eye Hospital, Tehran, Iran

    Reza Zarei, Mehrbod Ghasempour, Ghasem Fakhraie, Yahya Eslami, Massood Mohammadi, Nikoo Hamzeh, Fereydun Sajadi & Mona Safizadeh

Authors
  1. Reza Zarei
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  2. Mehrbod Ghasempour
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  3. Ghasem Fakhraie
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  4. Yahya Eslami
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  5. Massood Mohammadi
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  6. Nikoo Hamzeh
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  7. Fereydun Sajadi
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  8. Mona Safizadeh
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Correspondence to Mona Safizadeh.

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Conflict of interest

The authors declare that they have no conflict of interest.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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Patients signed informed consent regarding publishing their data.

Availability of material

The raw data are available at Farabi Eye Research Center.

Ethics approval

Approval was obtained from the ethics committee of Tehran University of Medical Sciences (No: IR.TUMS.REC.1395.2843). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Zarei, R., Ghasempour, M., Fakhraie, G. et al. Ahmed glaucoma valve implantation with and without subconjunctival bevacizumab in refractory glaucoma. Int Ophthalmol 41, 1593–1603 (2021). https://doi.org/10.1007/s10792-021-01691-7

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  • DOI: https://doi.org/10.1007/s10792-021-01691-7

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