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Adjunctive Use of Bevacizumab Versus Mitomycin C With Ahmed Valve Implantation in Treatment of Pediatric Glaucoma

Mahdy, Reda Abdel Rahman MD

doi: 10.1097/IJG.0b013e3181efbea5
Original Studies

Purpose Evaluate the use of bevacizumab (avastin) injected around valve body intraoperatively versus the use of mitomycin C as a single intraoperative application at the site of Ahmed valve implantation to enhance the survival of Ahmed valve in cases of pediatric glaucoma's as regarding the efficacy and complications.

Method Twenty eyes of 16 patients with pediatric glaucoma underwent Ahmed valve implantation with bevacizumab (avastin) (1.25 mg in 0.05 mL) injected around the valve body after completing the surgery compared with 20 eyes of 14 patients with pediatric glaucoma who underwent Ahmed valve implantation with application of mitomycin C (0.4 mg/mL for 3 min) before valve implantation and 20 eyes of 18 patients managed by Ahmed valve only (control group). The follow-up period was 12 months.

Results The results revealed that 80% total success (70% complete success and 10% qualified success) in first group in which avastin augmented Ahmed valve was performed compared with group II in which mitomycin C was used during Ahmed valve implantation 90% total success (80% complete success and 10% qualified success) and this difference between the 2 groups was nonsignificant (P>0.05), but in group III complete success occurred in (60%) only with no cases of qualified success (P>0.05).

Conclusions The adjunctive use of bevacizumab or mitomycin C during Ahmed valve implantation significantly enhances the valve survival and the first drug seems to be much safer with no visually devastating complications.

Department of Ophthalmology, Zagazig University, Zagazig, Egypt

The content has not been published or submitted for publication elsewhere.

The protocol for the research project has been approved by a suitably constituted Ethics Committee of the institution within which the work was undertaken and that it conforms to the provisions of the Declaration of Helsinki in 1995 (as revised in Tokyo 2004).

The subject gave informed consent and patient anonymity preserved.

Disclosure: The authors declare no conflict of interest.

The author is responsible for the content and writing of the article.

Reprints: Reda Abdel Rahman Mahdy, MD, Department of Ophthalmology, Faculty of Medicine, Zagazig University, Zagazig, Egypt (e-mail:

Received January 31, 2010

Accepted June 27, 2010

© 2011 Lippincott Williams & Wilkins, Inc.