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

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.