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Combined cataract and neovascular glaucoma surgery with Ex-PRESS™ glaucoma filtration device in conjunction with bevacizumab

Poster Details

First Author: V.Serdjuk UKRAINE

Co Author(s):    S. Ustimenko   V. Ishchenko   L. Bereznjuk        

Abstract Details


To test the EX-PRESS™ Glaucoma Filtration Device (GFD) in conjunction with Bevacizumab in patients with visually significant comlicated cataract and uncontrolled neovascular glaucoma (NVG) due to proliferative diabetic retinopathy (PDR)


Dnepropetrovsk regional clinical ophthalmologic hospital


Methods: A prospective non–randomized pilot study was performed on 14 eyes of fourteen patients with NVG due to PDR. Injection of bevacizumab (1.25 mg/0.05 mL) was performed under topical anesthesia 1 week befor combined surgery . The surgery consisted of performing microcoaxial phacoemulsification with IOL implantation and implantation of the ExPRESS GFD, under a 6x5mm scleral flap. Mitomycin C 0.2% solution was applied on the area of deep sclerectomy under the scleral flap for 3 minutes prior to the insertion of the ExPRESS shunt. Outcome measures included intra–ocular pressure (IOP), visual acuity , number of anti–glaucoma medications and complications.


preoperatively VA was from light perception to 0.01 sc. after one year follow up VA was 0,02-0,05 sc in 6 patients (43%), 0,05-0,1 sc in 5 patients (36%), 0,1-0,4sc in 3 patients( 21%). The overall mean (ḟSD) IOP preoperatively was 46.7 mmHg (ḟ4.5). One year post–operatively The operation was successful (IOP 21 mmHg , the overall mean IOP was 18.2 mmHg (ḟ2.7) without antiglaucoma medications) in ten of fourteen cases ( 86 %) Pre–operatively all the patients used anti–glaucoma medications. At one year, ten patients were not using anti–glaucoma medications. In two patients IOP was uncontrolled due to bleb fibrosis . These patiens needed bleb revision to remove scar tissue. 5 ( 36%) patients required repeated injections of bevacizumab due to recurrent iris neovascularisation. . There were no episodes of post–operative hypotony.


Implantation of Ex-Press GFD made it possible to achieve stable IOP in 86% of patients. Intravitreal bevacizumab is a useful preparatory step to safely and effectively implant an ExPRESS GFD and perform cataract surgery in NVG . In our opinion implantation of Ex-Press devise should be performed at early stages of NVG.

Financial Disclosure:


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