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Postoperative subconjunctival bevacizumab administration in the management of wound healing modulation after trabeculectomy

Poster Details

First Author: V.Popescu ROMANIA

Co Author(s):    S. Gradinaru   M. Totir   R. Ciuluvica   S. Yasin   C. Leasu   S. Pricopie

Abstract Details

Purpose:

Scarring at the sclerostomy site after glaucoma filtration surgery remains the main cause for bleb failure. The aim of this study was to determine the effect of post-trabeculectomy bevacizumab administration on the intraocular pressure (IOP) outcome, bleb morphology and vascularity, postoperative antiglaucoma medication and complications.

Setting:

Department of Ophthalmology, University Emergency Hospital, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania

Methods:

35 glaucomatous patients who underwent trabeculectomy were recruited and randomly allocated into two groups. Each group received a subconjunctival injection of 1.25mg (0.05mL) bevacizumab and respectively 0.05mL balanced salt solution (BSS) at completion of the trabeculectomy and one month later. Primary outcome, bleb vascularity was evaluated by slit-lamp examination and concomitant photographic documentation. Secondary endpoints, including intraocular pressure (IOP) outcome, bleb morphology, postoperative antiglaucoma medication and complications were recorded at baseline, day one, one week, one month, three months, six months, as well as for primary outcome.

Results:

35 eyes completed this prospective study, 20 of whom were in the bevacizumab group, with a follow-up of 6 months. In the study group, the reduction in vascularity of the functional bleb was statistically significant (p=o.oo1). Bleb morphological analysis was made using Indiana Bleb Appearance Grading Scale. IOP measurements did not significantly differ between treatment groups at any interval. Postoperative complications rates were low and there were no differences between groups. The mean number of patients who received anti-glaucoma medications in the study group was statistically significant lower than in the control group (P=0 .001).

Conclusions:

Postoperative administration of subconjunctival bevacizumab significantly reduces the need for additional glaucoma medication during the follow-up of patients undergoing glaucoma filtration surgery. In this pilot study, a reduction in bleb vascularity was observed after two subconjunctival bevacizumab administrations at one month interval as an adjunct to trabeculectomy.This paper is partly supported by the Sectorial Operational Programme Human Resources Development (SOPHRD), financed by European Social Found and the Romanian Government under the contract number POSDRU/159/1.5/S/137390.

Financial Disclosure:

NONE

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