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Effect of prior glaucoma surgery on intraocular pressure immediately after anti-vascular endothelial growth factor injection

  • Glaucoma
  • Published:
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Abstract

Background

To characterize how prior incisional glaucoma surgery affects the intraocular pressure (IOP) elevation immediately following intravitreal anti-VEGF injections (IVI).

Methods

Single institution, experimental study. Patients with a history of incisional glaucoma surgery who were receiving anti-VEGF injections were recruited as well as control eyes. Pre- and post-injection IOP measurements were compared as well as time to recovery to within 5 and 10 mmHg of baseline IOP.

Results

Ten eyes with a history of glaucoma surgery and 29 control eyes receiving anti-VEGF injections were included. The most common indication for intravitreal anti-VEGF injection was proliferative diabetic retinopathy in both surgical and control eyes (50% vs 45%, p = 1.00). Post-injection IOP was significantly decreased compared to baseline IOP after anti-VEGF injection in surgical versus control eyes (26.5 ± 8.9 mmHg vs 44.2 ± 8.5 mmHg, respectively, p < 0.001). The mean change in IOP following intravitreal anti-VEGF injection was lower in surgical eyes (10.7 ± 6.6 mmHg vs 28.6 ± 8.3 mmHg, p < 0.001). The mean time for the IOP to return to within 10 mmHg of pre-injection IOP was less in surgical eyes (5.2 ± 4.1 min vs 13.3 ± 7.6 min, p = 0.002).

Conclusions

Eyes with prior incisional glaucoma surgery demonstrated a significantly lower post-injection IOP elevation and a faster recovery to within 10 mmHg of their pre-injection IOP. Incisional glaucoma surgery may be considered for patients where the attenuation of post-injection IOP elevation is needed and other less invasive measures have failed.

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Acknowledgments

This work was supported by the National Institutes of Health Core Grant EY001830 and by an unrestricted departmental grant from Research to Prevent Blindness.

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No funding was received for this research.

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Authors and Affiliations

  1. Department of Ophthalmology, University of Washington, 325 9th Ave, PO Box 359608, Seattle, WA, 98104-2499, USA

    Jocelyn Lam, Ian Luttrell, Leona Ding, Kasra Rezaei, Jennifer R. Chao, Yewlin Chee, Lisa C. Olmos De Koo & Joanne C. Wen

Authors
  1. Jocelyn Lam
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  2. Ian Luttrell
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  3. Leona Ding
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  4. Kasra Rezaei
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  5. Jennifer R. Chao
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  6. Yewlin Chee
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  7. Lisa C. Olmos De Koo
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  8. Joanne C. Wen
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Corresponding author

Correspondence to Joanne C. Wen.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Washington and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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

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Lam, J., Luttrell, I., Ding, L. et al. Effect of prior glaucoma surgery on intraocular pressure immediately after anti-vascular endothelial growth factor injection. Graefes Arch Clin Exp Ophthalmol 257, 2489–2494 (2019). https://doi.org/10.1007/s00417-019-04431-x

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  • DOI: https://doi.org/10.1007/s00417-019-04431-x

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