Abstract #82667 Published in IGR 20-4

Postoperative adjunctive bevacizumab versus placebo in primary trabeculectomy surgery for glaucoma

Muhsen S; Compan J; Lai T; Kranemann C; Birt C
International Journal of Ophthalmology 2019; 12: 1567-1574

AIM: To compare the effectiveness of postoperative adjunctive use of subconjunctival bevacizumab in altering the outcome of primary trabeculectomy in terms of sustained lowering of intraocular pressure (IOP) and reduction of postoperative bleb vascularization and fibrosis. METHODS: A prospective, one center, randomized, placebo-control study. Fifty-nine patients (59 eyes) with uncontrolled IOP under maximal tolerated medical treatment (MTMT) were recruited. A primary trabeculectomy with mitomycin C (MMC) was done and the patients were randomized to either postoperative subconjunctival injection of bevacizumab (1.25 mg/0.05 mL) or balanced salt solution (BSS). Forty-seven patients (47 eyes) completed at least one year of follow up and were included in the study. The main outcome measure was the IOP, and secondary outcome measures include bleb morphology, vascularization, and fibrosis, as well as the need for glaucoma medications and 5-fluorouracil (5-FU) needling. RESULTS: At 1-year follow up, there was no significant difference between groups for IOP (=0.65), bleb morphology (=0.65), and the need for glaucoma medications (=0.65) or 5-FU needling requirements (=0.11). However, the bevacizumab group had a higher rate of success results, lower use of glaucoma medications after surgery, and optimal bleb aspect in more patients, but more 5-FU needling procedures required. CONCLUSION: A bigger sample size is needed in order to determine whether the differences found in the bevacizumab group are statistically significant.

Department of Ophthalmology, School of Medicine, The University of Jordan, Amman 11942, Jordan.

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12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
11.15 Other drugs in relation to glaucoma (Part of: 11 Medical treatment)

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