Authors: Natalia Maes, John Liu, Steven Schendel, Gavin Docherty, Carol Tadrous

Author Disclosure Block: N. Maes: None. J. Liu: None. S. Schendel: None. G. Docherty: None. C. Tadrous: None.

Abstract Body:

Purpose: To highlight the elevated number of Glaucoma surgeries related to the use of intravitreal antivascular endothelial growth factor (anti-VEGF) over a period of 18 months (from January/2016 to July/2017), under the care of one glaucoma surgeon in Vancouver, British Columbia.

Study Design: Observational-descriptive-case series

Methods: All Glaucoma surgeries performed during this period were retrospectively reviewed. The patients who were undergoing intravitreal Anti-VEGF treatment at the time of surgery were included in this analysis. Those who developed Neovascular Glaucoma or required intravitreal steroid, at any point over 18 months, were excluded. Patient’s age and gender were collected, as well as lens status, previous diagnosis of Glaucoma, previous SLT (selective laser trabeculoplasty), glaucoma surgery performed, subtype of anti-VEGF and retinal disease. The mean drops required for pressure treatment, visual acuity and intraocular pressure (IOP) before, 6 and 12 months after the surgery were also assessed.

Results: A total of 430 Glaucoma surgeries were performed. From which 121 (28.14%) were carried out in the context of anti-VEGF treatment. The mean age of the subjects was 75.61 years. The mean interval time between the first consult with the glaucoma specialist and the date of surgery was 3.8 months. Of the cases, 41 (33.88%) were previously known to have glaucoma or were glaucoma suspects and 80 (66.11%) did not have glaucoma or ocular hypertension before starting the Anti-VEGF treatment. The mean IOP before surgery was 37.18 mmHg. There was a decline of 63.28% after 12 months, leading to a final mean pressure of 13.65 mmHg.

Conclusions: A surprisingly elevated rate of Glaucoma surgeries has been observed among patients on anti-VEGF treatment in Vancouver. To the best of our knowledge, this inflated number of surgeries has not been reported worldwide. Additional data on Visual outcomes and Visual Fields are being collected.