Ws Suh

The Effect of Bevacizumab on the Outcome of Trabeculectomy with 5-Fluorouracil

BACKGROUNDnTo evaluate the effect of bevacizumab in trabeculectomies with 5-fluorouracil (5-FU).nnnMETHODSnThirty-six patients with uncontrolled glaucoma were included. Twelve patients underwent trabeculectomies with intracameral and subconjunctival injections of bevacizumab (1.25u2009mg/0.05u2009mL) and subconjunctival injections of 5-FU (5.0u2009mg/0.5u2009mL). The control group underwent trabeculectomies with subconjunctival injections of only 5-FU (5.0u2009mg/0.5u2009mL). The outcome measures, including best-corrected visual acuity, intraocular pressure (IOP), number of IOP-lowering medications, the assessment of bleb, and surgical complications, were evaluated until postoperative 24 months.nnnRESULTSnAt each follow-up visit, there were no statistically significant differences between the 2 groups with regard to all outcome measures (P>0.05). The cumulative probabilities of surgical success were 50% and 58.33% in trabeculectomy with bevacizumab and 5-FU and in trabeculectomy with 5-FU, respectively (P=0.68, log-rank test).nnnCONCLUSIONSnBevacizumab may not exert significant additive effects in trabeculectomy when administered in conjunction with 5-FU.

Visual and structural prognosis of the untreated fellow eyes of unilateral normal tension glaucoma patients

PurposeTo investigate the visual and structural prognosis of untreated initial non-glaucomatous fellow eyes of unilateral normal tension glaucoma (NTG) patients.MethodsIn this retrospective observational cohort study, 50 NTG patients with unilateral visual field (VF) loss and no VF defect, retinal nerve fiber layer (RNFL) defect or neuroretinal rim (NRR) notching in the fellow eyes, and those who had initial non-glaucomatous fellow eyes untreated were included. For the fellow eyes, the development of VF defect, RNFL defect, and NRR notching was inspected retrospectively by two observers. Baseline clinical characteristics including initial intraocular pressure (IOP), central corneal thickness, and spherical equivalent (SE) were compared between glaucomatous and fellow eyes.ResultsDuring the mean follow-up period of 8.77u2009±u20092.92xa0years, five patients (10xa0%) developed RNFL defect and four patients (8xa0%) developed NRR notching in the fellow eye. Among six patients (12xa0%) who had developed either RNFL defect or NRR notching, only three patients (6xa0%) developed VF loss in 1.81, 3.09, and 9.27xa0years respectively. The initial IOP was significantly higher (pu2009=u20090.031), SE was more myopic (pu2009=u20090.025), and the occurrence of disc hemorrhage (pu2009=u20090.049) was significantly higher in glaucomatous eyes than that in fellow eyes.ConclusionsThe incidence of glaucoma development in the fellow eye is rather low. Therefore, the initial non-glaucomatous fellow eye of the unilateral NTG patient may be observed without treatment until glaucoma develops.