Meta Analysis Of Outcome Of Anti VEGF As A Adjutant With Ahmed Glaucoma Valve Implantation In Treatmen Of Neovascular Glaucoma

Purpose: To evaluate the effects of adjuvant intravitreal anti vascular endothelial growth factor(anti VEGF)injection on the outcomes of Ahmed glaucoma valve(AGV)implantation in patients with neovascular glaucoma(NVG)through a systematic literature review.Methods: By searching though Pubmed,The Cochrane Library,EMBASE,QVIP,CNKI,Wanfang,the literatures about with or without anti-VEGF intravitreal injection preoperative or intaoperaive in patients wih NVG who needed to undergo a Ahmed glaucoma valve implantation,and the literatures were published before January 1st 2017 were collected.Seven studies were included in this analysis.By extracting the data,using Comprehensive Meta Analysis 2.0 software,the decrease of intraocular pressure(the difference between the baseline IOP and the IOP at the end of observation)IOPR was used as the main evaluation index.The odds ratios(OR)and 95% confidence intervals(CI)of the operation success rate as a secondary measure(complete and incomplete).Postoperative complications were also analyzed.Results:Seven studies involving 299 patients(308 eyes)were included in this systematic review.The analysis results show that the difference of IOP in NVG patients who undergone Ahmed glaucoma valve implantation with adjutant of intravireal anti VEGF is 4.182 ±1.765 mm Hg lower than those without anti VEGF(P<0.05).There is no statistically difference about operation success rate between two groups.The use of anti VEGF can reduce the postoperative complication such as hyphema.Conclusion: Anti VEGF as an adjutant for glaucoma valve implantation is more effective in reducing intraocular pressure,compared with simple glaucoma valve implantation.There was no significant difference between the two groups in the success rate of surgery.The use of anti VEGF can reduce postoperative complications such as hyphema.