Subconjunctival Bevacizumab Versus Mitomycin C Adjunctive to Trabeculectomy

Purpose To compare the outcome of trabeculectomy with subconjunctival bevacizumab with that of trabeculectomy with mitomycin C (MMC). Design Prospective, randomized, comparative study. Methods Thirty-six eyes from 34 patients with uncontrolled glaucoma were enrolled. Eighteen eyes underwent trabecul...

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Veröffentlicht in:American journal of ophthalmology 2012-02, Vol.153 (2), p.352-357.e1
Hauptverfasser: Nilforushan, Naveed, Yadgari, Maryam, Kish, Shahin Khosh, Nassiri, Nariman
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Sprache:eng
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Zusammenfassung:Purpose To compare the outcome of trabeculectomy with subconjunctival bevacizumab with that of trabeculectomy with mitomycin C (MMC). Design Prospective, randomized, comparative study. Methods Thirty-six eyes from 34 patients with uncontrolled glaucoma were enrolled. Eighteen eyes underwent trabeculectomy with subconjunctival bevacizumab injection (2.5 mg/0.1 mL), and 18 eyes underwent trabeculectomy with MMC (0.02% for 3 minutes). The outcome measures were the best-corrected visual acuity, intraocular pressure (IOP), number of IOP-lowering medications, complications, and bleb morphologic features (based on the Indiana Bleb Appearance Grading Scale). Results The mean follow-up times for the MMC and bevacizumab groups were 7.8 ± 2.2 months and 7.4 ± 24 months, respectively ( P = .62). The mean preoperative IOP in the bevacizumab group improved from 21.9 ± 7.9 mm Hg with 2.7 ± 0.8 antiglaucoma medications to 13.6 ± 3.2 mm Hg with 0.2 ± 0.5 antiglaucoma medications at the last visit ( P < .001 and P < .001, respectively). The mean preoperative IOP in the MMC group improved from 23.3 ± 4.9 mm Hg with 2.6 ± 0.7 antiglaucoma medications to 9.6 ± 2.7 mm Hg with no antiglaucoma medications at the final visit ( P < .001 and P < .001, respectively). There was a statistically significant difference in the IOP between the 2 groups at the last visit ( P < .001). The cumulative probabilities of total success at the last follow-up according to Kaplan-Meier analysis were 100% and 94.4% in bevacizumab and MMC groups, respectively ( P = .32, log-rank test). Conclusions Adjunctive subconjunctival bevacizumab with trabeculectomy is effective in controlling the IOP profile; however, its effect is less prominent than that of MMC.
ISSN:0002-9394
1879-1891
DOI:10.1016/j.ajo.2011.08.005