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Abstract #49238 Published in IGR 14-1
Bleb vascularity following post-trabeculectomy subconjunctival bevacizumab: a pilot study
Chua BE; Nguyen DQ; Qin Q; Ruddle JB; Wells AP; Niyadurupola N; Gupta V; Wong TT; Coote MA; Crowston JGClinical and Experimental Ophthalmology 2012; 40: 773-779
BACKGROUND: To determine whether postoperative subconjunctival bevacizumab significantly alters bleb vascularity. DESIGN: A randomised, prospective interventional study. PARTICIPANTS: 43 eyes from 39 patients were recruited, with 21 eyes randomised to subconjunctival injections of 5-FU, and 22 eyes to combined 5-FU/bevacizumab. METHODS: All patients who underwent uncomplicated primary anti-metabolite augmented trabeculectomy who subsequently required post-operative subconjunctival 5-Fluorouracil (5-FU) injection within 4 weeks of surgery were eligible. Patients were randomised to receive subconjunctival 5-FU only (7.5mg/0.15ml) or 5 FU plus bevacizumab (1.25mg/0.05ml). MAIN OUTCOME MEASURES: Primary outcome was bleb vascularity with secondary endpoints including visual acuity (VA), intraocular pressure (IOP), bleb morphology, complications and total numbers of 5-FU injections were recorded at baseline, week 12 and 18 months. RESULTS: At week 12, there was no significant difference between groups for VA, IOP, bleb vascularity and morphology or total number of 5-FU injections. By 18 months, 47.4% of the 5-FU/bevacizumab group exhibited central bleb avascularity compared to 21.1% of the 5 FU group (Fisher exact test, p = 0.17). 2 bleb complications (1 blebitis; 1 suture abscess) recorded in the 5 FU/bevacizumab group. CONCLUSIONS: After a single combined injection a trend for increased central bleb avascularity was observed; although this effect was not sufficient to reach statistical significance. This in addition to the occurrence of two bleb related complications in the bevacizumab group suggest the need for a larger clinical trial to further evaluate the safety and efficacy of bevacizumab as a modulating agent in glaucoma filtration surgery.
Centre for Eye Research Australia, Department of Ophthalmology, University of Melbourne, Australia.
Full articleClassification:
11.15 Other drugs in relation to glaucoma (Part of: 11 Medical treatment)
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
