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ORIGINAL ARTICLE
Year : 2013  |  Volume : 106  |  Issue : 2  |  Page : 130-133

Goniocurettage augmented by intracameral bevacizumab in uveitic glaucoma


Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence Address:
Lamia S Elewa
Faculty of Medicine, Ain Shams University, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.7123/01.JEO.0000431553.54184.32

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Purpose

The aim of the study was to report the results of goniocurettage augmented by intracameral bevacizumab (Avastin) in controlling uveitic glaucoma.

Design

This is a prospective, interventional study.

Patients and methods

Thirteen eyes of 13 patients, whose mean age was 46.3 (5.17 SD) years and who had chronic uveitis associated with medically uncontrolled glaucoma and strictly controlled intraocular inflammation, underwent intracameral injection of bevacizumab (1.00 mg/0.04 ml) as the initial treatment. One week later goniocurettage was performed under direct visualization of the angle through a gonioscopy lens (Thorpe/Swan–Jacob lens). The trabecular tissue (membrane) was scraped about 90π to 120πof the anterior chamber (AC) angle circumference. Follow-up included evaluation of intraocular pressure, best corrected visual acuity (BCVA), uveitic control, number of antiglaucoma medications, and intraoperative and postoperative complications.

Results

The mean follow-up period was 6.7 (1.5 SD) months (range 6–8). The mean pretreatment intraocular pressure averaged 41.3 (7.8 SD) mmHg (range 32–50 mmHg) and was significantly (P<0.04) reduced to 26.3 (5.2 SD) mmHg (range 18–26 mmHg), a net decrease of 36% by the end of the mean follow-up period. Eleven eyes (85%) had stable BCVA. BCVA improved in two eyes by one Snellen’s chart line. In two eyes a minor reflux of blood occurred at the treatment site. However, no hypotony, choroidal effusion, flattened anterior chamber, or cyclodialysis was observed in any patient. We reported total success in 77% of eyes, complete success in four eyes (31%), and qualified success in six eyes (46%).

Conclusion

Goniocurettage is an effective and safe procedure for short-term control of glaucoma in uveitic eyes. Intracameral injection of bevacizumab may be a helpful adjunct.



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