Postoperative adjunctive bevacizumab versus placebo in primary trabeculectomy surgery for glaucoma

作     者：Sana’Muhsen Javiera Compan Tze Lai Christoph Kranemann Catherine Birt 

作者机构：Department of OphthalmologySchool of MedicineTheUniversity of JordanAmman11942Jordan Department of Ophthalmology and Vision SciencesUniversity of TorontoToronto ON M4N3M5Canada Department of OphthalmologyCurtin UniversityWesternAustraliaGPO Box U1987Perth WA6845Australia 

出 版 物：《International Journal of Ophthalmology(English edition)》 (国际眼科杂志（英文版）)

年 卷 期：2019年第12卷第10期

页      面：1567-1574页

核心收录：

学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学] 

基　　金：Supported by the Glaucoma Research Society of Canada 

主　　题：glaucoma trabeculectomy bevacizumab bleb 

摘      要：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 ***: 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) ***: At 1-year follow up, there was no significant difference between groups for IOP(P=0.65), bleb morphology(P=0.65), and the need for glaucoma medications(P=0.65) or 5-FU needling requirements(P=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.