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Bevacizumab injection and ligation of pterygium’s head: a case report

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Session Details

Session Title: Presented Poster Session: Cornea II

Venue: Poster Village: Pod 2

First Author: : C.Carranza SPAIN

Co Author(s): :    M. Srur   I. Del Cerro   I. Maestre   B. Moreno   J. Riba  

Abstract Details

Purpose:

Pterygium is a fibrovascular hyperplastic growth of the conjunctiva at the limbus of the eye. There have been some attempts to use Bevacizumab as a sole treatment without achieving the expected results; moreover it also has been used as an adjuvant therapy after pterygium excision with inconclusive results. We would like to present a case report of a patient with a novel management of pterygium by injection of Bevacizumab and ligation of Pterygium’s head, which can give an alternative treatment to resection with autograft.

Setting:

General University Hospital Gregorio Marañon – Provincial Institute of ophthalmology of Madrid. We performed the procedure in the operation room of our institute under aseptic conditions and the patient review appointment was in the ophthalmology consultation under slit lamp examination.

Methods:

A 56 years old patient with bilateral pterygium. We investigated her medical history and made a complete ophthalmic examination. We entered the operation room. After topical anesthesia we cleansed the skin and conjunctiva with betadine™, then we injected subconjunctival Bevacizumab 1,25mg and ligated pterygium’s head with Polysorb™ 8.0 in her left eye. We gave her Tobradex™ and Cicloplejico™ for the first week. We checked the patient at 24 hours, after 1 week and at one month after the procedure. We took out the suture after one week from the procedure and took pictures in every appointment.

Results:

We observed ischemia of the Pterygium’s head 24 hours after the procedure and the patient noticed dry eye feeling but no pain. After the first week there was regression and flattening of the head with initial engorgement of the body, it also presented subconjunctival hemorrhages. After a month of the treatment the patient presented regression of the body, the dry eye feeling decreased and there were no subconjunctival hemorrhages.

Conclusions:

Ligation of the head of the Pterigium has been performed previously with failure of this procedure because of secondary neovascularization. Treatment has also been attempted only with subconjunctival Bevacizumab with decreased symptomatology and decreased vascular engorgement but no regression of the pterygium’s head. When we performed ligation of the head after the injection of Bevacizumab, we achieved a longer permanence of the drug in pterygium’s head; moreover its ischemia also promoted death of the fibrovascular tissue, therefore the results presented. We recommend expanding the number of cases and the follow-up time to assess the efficacy of this treatment.

Financial Disclosure:

NONE

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