Cyclodiode settings for rubeotic glaucoma

• 40 shots, 270 degrees, 1500mw   1500ms
• spare 3 and 9 o'clock and temporal position
• if pops, turn power lower
• this is far more laser than needed than non-rubeotic cases
• transilluminate ciliary body (in the dark) to find it (shine the light form the opposite side of the eye)
• heel 1.5mm away from limbus in standard eye
• avoid pops and carbon on the probe
• lots of risks
• see glaucoma for professionals

IVA (Avastin...Bevacizumab)

• is very effective in reducing rubeosis   see   Avastin
• won't low the pressure if angle is blocked with fibrotic changes (PAS)...cyclodiode is needed in addition
• if condition is caught early, use Avastin early. If vessels are aggressive, do not wait for drops to work (drops alone are usually not effective with significant rubeosis)
• drops...steroid and atropine
• lowering the pressure helps reduce the rubeosis
• in an eye that sees well consider early tube surgery...Avastin and drops whilst waiting.

Iliev ME, Domig D, Wolf-Schnurrbursch U, Wolf S, Sarra GM.
Intravitreal bevacizumab (Avastin) in the treatment of neovascular glaucoma.
Am J Ophthalmol. 2006 Dec;142(6):1054-6. Epub 2006 Aug 2.

Gheith ME, Siam GA, de Barros DS, Garg SJ, Moster MR.
Role of intravitreal bevacizumab in neovascular glaucoma.
J Ocul Pharmacol Ther. 2007 Oct;23(5):487-91.

Vatavuk Z, Bencic G, Mandic Z.
Intravitreal bevacizumab for neovascular glaucoma following central retinal artery occlusion.
Eur J Ophthalmol. 2007 Mar-Apr;17(2):269-71.

Kahook MY, Schuman JS, Noecker RJ.
Intravitreal bevacizumab in a patient with neovascular glaucoma.
Ophthalmic Surg Lasers Imaging. 2006 Mar-Apr;37(2):144-6.

Yazdani S, Hendi K, Pakravan M.
Intravitreal bevacizumab (Avastin) injection for neovascular glaucoma.
J Glaucoma. 2007 Aug;16(5):437-9.

Grisanti S, Biester S, Peters S, Tatar O, Ziemssen F, Bartz-Schmidt KU; Tuebingen Bevacizumab Study Group.
Intracameral bevacizumab for iris rubeosis.
Am J Ophthalmol. 2006 Jul;142(1):158-60.

Chilov MN, Grigg JR, Playfair TJ.
Bevacizumab (Avastin) for the treatment of neovascular glaucoma.
Clin Experiment Ophthalmol. 2007 Jul;35(5):494-6.

 Kelkar AS, Kelkar SB, Kelkar JA, Nagpal M, Patil SP.
The use of intravitreal bevacizumab in neovascular glaucoma: a case report.
Bull Soc Belge Ophtalmol. 2007;(303):43-5.

Silva Paula J, Jorge R, Alves Costa R, Rodrigues Mde L, Scott IU.
Short-term results of intravitreal bevacizumab (Avastin) on anterior segment neovascularization in neovascular glaucoma.

Oshima Y, Sakaguchi H, Gomi F, Tano Y.
Regression of iris neovascularization after intravitreal injection of bevacizumab in patients with proliferative diabetic retinopathy.