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Unexpected Hypotony After Glaucoma Drainage Implant Surgery Associated With Anti–Vascular Endothelial Growth Factor Treatment

Ambika Hoguet, MD1; Richard K. Parrish II, MD2
[+] Author Affiliations
1Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston
2Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
JAMA Ophthalmol. 2015;133(3):349-350. doi:10.1001/jamaophthalmol.2014.5058.
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Anti–vascular endothelial growth factor (VEGF) agents are used for the treatment of neovascular age-related macular degeneration (AMD). These agents may also affect wound healing and decrease bleb vascularity after trabeculectomy.1 We are not aware of any reports of the effects of anti-VEGF agents on wound healing after glaucoma drainage implant (GDI) surgery. We describe reduced bleb vascularity and unexpectedly prolonged hypotony in 2 patients after GDI surgery who received multiple injections of anti-VEGF agents.

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Figure.
Appearance of Bleb Over Glaucoma Drainage Implant Plate

Cases 1 (A) and 2 (B) at postoperative week 12. Both show a thin, minimally vascular bleb that has formed over the glaucoma drainage implant plate.

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