Subconjunctival bevacizumab injection in glaucoma filtering surgery: a case control series

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Vascular Endothelial Growth Factor Inhibitors

Background:

• Glaucoma filtering surgery (GFS) aims to reduce intraocular pressure (IOP).
• Subconjunctival bevacizumab (SCB) is an anti-VEGF agent sometimes used post-operatively.
• The efficacy and safety of SCB in conjunction with GFS require evaluation.

Purpose of the Study:

• To assess the use and outcomes of subconjunctival bevacizumab (SCB) injections following combined cataract and glaucoma filtering surgery (GFS).
• To compare IOP reduction and medication use between patients receiving SCB and a control group.

Main Methods:

• Retrospective comparative case series of 30 eyes (28 patients) receiving GFS with SCB post-operatively.
• Control group comprised age-matched patients with similar GFS but no SCB.
• Outcome measures included IOP reduction and medication requirements; follow-up averaged 16.9 months.

Main Results:

• Mean IOP reduction was observed in both groups, but no statistically significant difference was found between SCB and control groups (P = 0.11).
• Average IOP decreased from 19.6 mmHg to 14.0 mmHg in the SCB group.
• Three cases of branch vein occlusion were noted as complications in the SCB group.

Conclusions:

• Subconjunctival bevacizumab (SCB) did not demonstrate improved intraocular pressure (IOP) reduction compared to standard post-GFS care.
• Clinicians should exercise caution and monitor for adverse events, such as vascular occlusions, when using SCB in glaucoma patients.