Evaluation of efficacy and safety of subconjunctival bevacizumab injection during Ahmed glaucoma valve surgery

Forty-nine eyes of 49 patients with diagnosis of refractory glaucoma that were candidate for Ahmed glaucoma valve surgery were enrolled in this study. Patients were selected randomly in conventional Ahmed glaucoma valve surgery (group 1) or Ahmed glaucoma valve surgery with 2.5 mg sub conjunctival bevacizumab injection (group 2). The primary outcome measure was surgical success: post-operative IOP ≤ 21 mm Hg with at least 20% reduction in IOP, either with no medication (complete success) or with no more than 2 medications (qualified success). At the end of study data analysis was performed using SPSS software version 20.

Mean age of patients was 60.9±17.8 and 50.8 ±14.26 years in group 1 and 2 respectively (P<0.001). Mean duration of follow up was 13.4±5.2 and 10.4 ±4.0 months in group 1 and 2 respectively (P<0.001). IOP decreased from 24.7±6.5 preoperatively to 15.4±4.4 in group 1 and from 27.81±7.7 to 13.42 ±2.9 in group 2. (P<0.001 in both groups) The number of anti –glaucoma medications was 2.9±0.6 before surgery in group 1 and 3.4 ±0.5 in group 2 that decreased to 1.7±1.1 and 1.3±0.86 respectively in last follow up. (P<0.001 in both groups). Cumulative success was 80% and 95.8% in group 1 and 2 respectively (P=0.79)

Although we observed significant decrease of IOP and glaucoma medications in both groups the difference between the cumulative success rate between two groups was not statistically significant.