Long-term Outcomes After Preoperative Intravitreal Injection of Bevacizumab Before Trabeculectomy for Neovascular Glaucoma

Purpose: To evaluate the long-term (> 3 y) outcomes of patients given preoperative intravitreal bevacizumab (IVB) injection before trabeculectomy for neovascular glaucoma (NVG). Method: We performed a retrospective study of a consecutive series of 12 eyes of 11 patients who underwent trabeculectomy with mitomycin C combined with preoperative IVB for NVG at our institution between April 2009 and April 2010. The mean follow-up period was 43.0 +/- 7.0 months (range, 36 to 51 mo), and all patients were followed up for at least 36 months. Surgical success was defined as an intraocular pressure (IOP) of <= 21 mm Hg with or without topical ocular hypotensive medication. Result: The cumulative surgical success rate was 83.3% at 1 year and 83.3% at 3 years. The mean IOP before surgery was 42.7 +/- 9.2 mm Hg, whereas the mean postoperative IOP was significantly lower, being 15.1 +/- 3.7 mm Hg at 1 year and 14.2 +/- 3.2 mm Hg at 3 years (P < 0.01). In contrast, no significant change of the mean visual acuity as compared with the preoperative visual acuity was observed at the follow-up carried out 3 years after the surgery. Intraoperative and early postoperative hyphema was seen in 2 eyes. Recurrence of neovascularization requiring additional IVB injection was seen in 3 eyes. Conclusions: Preoperative IVB injection before trabeculectomy for NVG might be effective over the long-term (> 3 y) control of the IOP.