Case Series
Eye (2009) 23, 979–981; doi:10.1038/eye.2008.113; published online 2 May 2008
Intravitreal bevacizumab and augmented trabeculectomy for neovascular glaucoma in young diabetic patients
K Spiteri Cornish1, S Ramamurthi1, S Saidkasimova1 and K Ramaesh1
1Department of Ophthalmology, Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, Scotland
Correspondence: KS Cornish, Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053, Great Western Road, Glasgow G12 0YN, Scotland. Tel: +014 121 130 00; Fax: +014 121 110 54; E-mail: kurtsc01@yahoo.co.uk
Received 17 January 2008; Revised 28 March 2008; Accepted 28 March 2008; Published online 2 May 2008.
Abstract
Purpose
To report two cases of young diabetic patients with intractable neovascular glaucoma (NVG) who were successfully managed with bevacizumab and mitomycin C-augmented trabeculectomy.
Results
Two young patients present with severe NVG secondary to diabetic proliferative retinopathy. The glaucoma was unresponsive to conventional medical therapy and complete panretinal photocoagulation. Both patients underwent augmented trabeculectomy with MMC and intravitreal injection of bevacizumab. Iris rubeosis resolved within 48 h. Both patients have a follow-up period of 6 months and the intraocular pressure (IOP) remain between 10–15 mmHg.
Conclusions
Controlling IOP due to NVG in young diabetic patients is difficult and augmented trabeculectomy has a very high failure rate. The addition of intravitreal bevacizumab in the management of NVG particularly in young diabetic patients may improve the success rate of IOP control. It is known that bevacizumab retards neovascularisation. It may also be modulating wound-healing response as well. Bevacizumab may have a potential role in the surgical management of NVG.
Keywords:
neovascular, glaucoma, bevacizumab, trabeculectomy; mitomycin
