The edition · Ophthalmology
One intravitreal bevacizumab dose at trabeculectomy linked to better three-year survival
A double-masked trial found higher trabeculectomy success at 36 months with a single bevacizumab injection alongside mitomycin C. Statin users had less glaucoma and less escalation in a large database, and combined angle surgery held pressure in advanced angle closure.
The edition in brief
In a single-centre, double-masked, placebo-controlled trial of 131 patients having trabeculectomy or phacotrabeculectomy with mitomycin C, a single intraoperative intravitreal dose of bevacizumab 1.25 mg was associated with higher surgical success at 36 months (hazard ratios 0.17 for complete and 0.07 for qualified success) and less need for drops; 85% completed follow-up. In a TriNetX database study of 210,701 matched adults over 40, statin use was associated with lower five-year risk of open-angle glaucoma (HR 0.85) and, among 29,598 people with glaucoma, less escalation to laser, MIGS or surgery. In 70 eyes with advanced primary angle-closure glaucoma without cataract, combined surgical peripheral iridectomy, goniosynechialysis and goniotomy lowered pressure from 29.4 to 16.4 mmHg at three years with qualified success of 84%, though cataract progressed in some. At nine years, a small follow-up of a ranibizumab versus laser ROP trial found similar acuity and refraction. The FDA recorded a supplement to a generic acetazolamide application on 21 September, an administrative action. The pearl covers the first steps in acute angle closure.
Statin users had less open-angle glaucoma and less treatment escalation
Statin use was associated with less glaucoma and less treatment escalation, but this does not justify prescribing statins for the eye.
Combined angle surgery in advanced angle closure without cataract: three-year results
Combined iridectomy, goniosynechialysis and goniotomy kept pressure controlled for three years in advanced angle closure, at the cost of some cataract progression.
Ranibizumab or laser for zone II ROP: similar vision at nine years
Nine years after zone II ROP treatment, ranibizumab and laser gave similar acuity and refraction in a small follow-up.
FDA records a supplement to a generic acetazolamide application
An administrative supplement to a generic acetazolamide licence; nothing changes in practice.
The first hour in acute angle closure
Lower the pressure fast, then relieve pupil block, and never forget the fellow eye.
One bevacizumab injection at trabeculectomy: better survival at three years
A single intravitreal bevacizumab dose at trabeculectomy with mitomycin C was linked to better three-year success; consider it in high-risk eyes with informed consent.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this one is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for ophthalmology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free