Intracameral Ranibizumab and Subsequent Mitomycin C Augmented Trabeculectomy in Neovascular Glaucoma

Abstract

The purpose of this study is to evaluate the efficacy of intracameral ranibizumab (ICR) injections with subsequent mitomycin C (MMC) augmented trabeculectomy in the management of neovascular glaucoma (NVG). This is a prospective, interventional study of NVG, with research conducted between January 2010 and February 2011, at the Ophthalmology Department of Kasr El-Aini Hospital and Petrol Medical Center (Cairo, Egypt). Fifteen patients with NVG were included in the study, all of whom received intracameral ranibizumab (ICR) injections (0.5 mg) into their eyes 4 weeks before MMC augmented trabeculectomies were performed. All patients were followed up for a period of 6 months. Thirteen eyes (86.7%) achieved absence of clinically apparent iris neovascularization after 1 ICR injection and 2 eyes (13.3%) after a second injection. Eight eyes (53.3%) achieved complete success [if the intraocular pressure (IOP) was between 10 and 21 mm Hg] without topical antiglaucoma medications, 6 eyes (40%) had qualified success (if the IOP was within the same range) but with topical antiglaucoma medications, and failure occurred in 1 eye (6.7%) (because the IOP was above 21 mm Hg) despite the use of topical antiglaucoma medications. An ICR injection with subsequent MMC augmented trabeculectomy seems to be an effective combined technique in controlling IOP in eyes with NVG.