Efficacy of Bevacizumab combined with EX-PRESS in the treatment of refractory glaucoma

• Main Author: Qian Wang
• Format: Article
• Language: English
• Published: Press of International Journal of Ophthalmology (IJO PRESS) 2018-03-01
• Series: Guoji Yanke Zazhi
• Subjects: intravitreal injection of bevacizumab; EX-PRESS; refractory glaucoma
• Online Access: http://ies.ijo.cn/cn_publish/2018/4/201804021.pdf

AIM:To investigate the efficacy of Bevacizumab intravitreal injection combined with EX-PRESS in the treatment of refractory glaucoma. <p>METHODS: The research objects were 150 cases(150 eyes)of patients with refractory glaucoma from June 2014 to December 2016 in our hospital. All patients were treated with EX-PRESS glaucoma drainage device implantation, and their medicine data were analyzed retrospectively. Totally 70 cases(70 eyes)were treated with EX-PRESS only were set as the control group; 80 cases(80 eyes)received bevacizumab intravitreal injection on the basis of the treatment of the control group were set as the observation group. The successful rate of operation was evaluated, the intraocular pressure was measured before operation and at 7d, 1, 3, 6mo after treatment by non-contact conometer, followed by record of the visual acuity and complications before and after 6mo of treatment. <p>RESULTS: The observation group's total surgical success rate was 72.5%, which was sharply higher than that of the control group(58.6%); while the partial success rate was 17.5%, which was significantly lower than that of the control group(30.0%), with statistical significance(<i>χ</i>²=5.453, <i>P</i>=0.028; <i>χ</i>²=4.213, <i>P</i>=0.047). Two groups' surgical failure rate had no distinct difference(<i>χ</i>²=0.000, <i>P</i>=1.000). There was no significant difference in visual acuity of the two groups before and after operation(<i>P</i>>0.05). There was no significant difference in intraocular pressure between the two groups(<i>F</i>_groups=982.27, <i>P</i><0.05; <i>F</i>_time=941.88, <i>P</i><0.05). The intraocular pressure of the two groups decreased significantly after treatment, and at the 7d observation group was significantly higher than that of the control group after operation(<i>P</i><0.05). After 1, 3, 6mo of operation, there was no abvious difference between two groups on IOP(<i>P</i>>0.05). The observation group's low intraocular pressure, anterior chamber bleeding and shallow anterior chamber incidence were significantly lower than those of the control group, there was statistical meaning(<i>P</i><0.05). <p>CONCLUSION: Intravitreal injection of bevacizumab combined with EX-PRESS in the treatment of refractory glaucoma can improve the complete success rate, as well as perform effective control on complications such as short-term intraocular pressure, hyphema, low intraocular pressure.