Bleb vascularity following post-trabeculectomy subconjunctival bevacizumab: a pilot study
| Autor: | Michael Coote, Dan Q Nguyen, Jonathan G Crowston, Tina T. Wong, Anthony P Wells, Brian E. Chua, Viney Gupta, Nuwan Niyadurupola, Jonathan B Ruddle, Queena Qin |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Intraocular pressure
medicine.medical_specialty Visual acuity genetic structures Bevacizumab business.industry medicine.medical_treatment Glaucoma medicine.disease eye diseases Surgery Ophthalmology Vascularity medicine Glaucoma surgery Trabeculectomy sense organs medicine.symptom Bleb (medicine) business medicine.drug |
| Zdroj: | Clinical & Experimental Ophthalmology. 40:773-779 |
| ISSN: | 1442-6404 |
| DOI: | 10.1111/j.1442-9071.2012.02798.x |
| Popis: | Background: To determine whether postoperative subconjunctival bevacizumab significantly alters bleb vascularity. Design: A randomized, prospective interventional study. Participants: Forty-three eyes from 39 patients were recruited, with 21 eyes randomized to subconjunctival injections of 5-fluorouracil, and 22 eyes to combined 5-fluorouracil/bevacizumab. Methods: All patients who underwent uncomplicated primary antimetabolite augmented trabeculectomy who subsequently required postoperative subconjunctival 5-fluorouracil injection within 4 weeks of surgery were eligible. Patients were randomized to receive subconjunctival 5-fluorouracil only (7.5 mg/0.15 mL) or 5-fluorouracil plus bevacizumab (1.25 mg/0.05 mL). Main Outcome Measures: Primary outcome was bleb vascularity with secondary endpoints including visual acuity, intraocular pressure, bleb morphology, complications and total numbers of 5-fluorouracil injections were recorded at baseline, week 12 and 18 months. Results: At week 12, there was no significant difference between groups for visual acuity, intraocular pressure, bleb vascularity and morphology, or total number of 5-fluorouracil injections. By 18 months, 47.4% of the 5-fluorouracil/bevacizumab group exhibited central bleb avascularity compared with 21.1% of the 5-fluorouracil group (Fisher's exact test, P = 0.17). Two bleb complications (one blebitis; one suture abscess) recorded in the 5-fluorouracil/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, suggests the need for a larger clinical trial to further evaluate the safety and efficacy of bevacizumab as a modulating agent in glaucoma filtration surgery. |
| Databáze: | OpenAIRE |
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