J Korean Ophthalmol Soc > Volume 57(4); 2016 > Article
Journal of the Korean Ophthalmological Society 2016;57(4):607-613.
DOI: https://doi.org/10.3341/jkos.2016.57.4.607    Published online April 15, 2016.
Intravitreal Bevacizumab and Subsequent Trabeculectomy with Mitomycin C for Neovascular Glaucoma with Previous Sutureless Vitrectomy.
Keun Heung Park, Hyo Chul Lim, Ji Woong Lee
1Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea. alertlee@naver.com
2Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
무봉합 유리체절제술 후 발생한 신생혈관녹내장 환자에서 시행한 섬유주절제술의 수술 성적
박건형1⋅임효철1⋅이지웅1,2
부산대학교 의과대학 안과학교실1, 부산대학교병원 의생명연구원2
Correspondence:  Ji Woong Lee
Received: 10 December 2015   • Revised: 6 February 2016   • Accepted: 12 March 2016
Abstract
PURPOSE
To evaluate the efficacy of intravitreal bevacizumab and subsequent trabeculectomy with mitomycin C (MMC) for neovascular glaucoma (NVG) in eyes that underwent previous 23-gauge transconjunctival sutureless vitrectomy (TSV). METHODS: This was a retrospective, comparative, and consecutive case series study. We reviewed the medical records of patients with NVG who underwent trabeculectomy with MMC after intravitreal bevacizumab (1.25 mg/0.05 mL) injection and compared the surgical outcomes according to 23-gauge TSV history. Surgical success was defined as an intraocular pressure (IOP) of ≥6 mm Hg and ≤21 mm Hg without additional glaucoma surgery or loss of light perception. The main outcome measures were postoperative IOP control, visual acuity, and complications. RESULTS: A total of 27 patients (27 eyes) were included; 12 patients with 23-gauge TSV history (TSV group) and 15 patients without vitrectomy history (nonvitrectomized group). The cumulative probability of success after trabeculectomy with MMC was 82.5% and 73.3% after one year for the TSV group and the nonvitrectomized group, respectively (p = 0.523). Mean IOP decreased from 37.3 ± 9.0 mm Hg preoperatively to 12.8 ± 6.2 mmHg at the final visit in the TSV group (p = 0.002). Mean IOP decreased from 40.3 ± 9.7 mm Hg preoperatively to 17.8 ± 11.7 mm Hg at the final visit in the nonvitrectomized group (p = 0.001). Preoperative and final IOP were not significantly different between the two groups. Complications were comparable between the groups. CONCLUSIONS: Intravitreal bevacizumab injection and subsequent trabeculectomy with MMC is an effective method for controlling IOP in patients with NVG associated with sutureless vitrectomy.
Key Words: Intravitreal bevacizumab injection;Neovascular glaucoma;Trabeculectomy with mitomycin C;Transconjuctival sutureless vitrectomy


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