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Clinical efficacy and safety of ExPRESS glaucoma device with Mitomycin C (MMC) in conjunction with bevacizumab in neovascular glaucoma patients due to proliferative diabetic retinopathy (PDR)

Poster Details

First Author: R.Hanna ISRAEL

Co Author(s):    B. Tiosano   D. Gaaton           

Abstract Details



Purpose:

To evaluate the efficacy and safety of Ex-Press implantation with mitomycin C (MMC) in conjunction with bevacizumab in neovascular glaucoma (NVG) patients due to proliferative diabetic retinopathy (PDR)

Setting:

Hillel yaffe medical center ophthalmic division

Methods:

This retrospective, case series study collected a total of 5 eyes of 5 patients with neovascular glaucoma who underwent Ex-Press implantation. MMC 0.2% was placed under the conjunctiva for one minute duration .The device was placed under a partial-thickness scleral flap by the same surgeon. Injection of bevacizumab (1.25mg/0.05ml) was performed one week to one month before surgery. Changes of intraocular pressure (IOP), the best corrected visual acuity, numbers of anti-glaucoma medications, success rate and postoperative complications were followed up at day 1, month 1, and every 3 months after surgery. Complete success of the procedure was defined as a reduction in IOP of more than 30% without medications.

Results:

The mean follow-up was 8.5± 6.8 months . Mean preoperative IOP was 33.6±5.6 mmHg and mean postoperative IOP at the last visit was 12.8 ± 3.0mmHg (P=0.001). The control of IOP was achieved at the final follow-up visits in all patients, however, 3 of 5 patients still needed anti-glaucoma medication (mean number of medications, 1.6± 1.5). The visual acuity worsened in one patient , improved in one patient , and was unchanged in the remaining three patients at the final follow -up visits. The postoperative complications include, postoperative hypertensive phase and intraoperative hyphema which were all controlled with additional treatment.

Conclusions:

The clinical outcome indicates that the Ex-Press implantation has a stable IOP lowering effect and low rate of complications, which can be considered as one of the first choices for management of NVG. FINANCIAL INTEREST: NONE

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