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Evaluation of subconjunctival bevacizumab as an adjunct to trabeculectomy a pilot study.

Publication ,  Journal Article
Grewal, DS; Jain, R; Kumar, H; Grewal, SPS
Published in: Ophthalmology
December 2008

PURPOSE: To determine whether bevacizumab can reduce bleb failure in patients undergoing first-time trabeculectomy for primary open-angle glaucoma (POAG) or chronic angle-closure glaucoma (CACG). DESIGN: Nonrandomized, open-label, prospective, interventional case series. PARTICIPANTS: Twelve individuals (7 males; 5 females) with a diagnosis of POAG or CACG, a recorded intraocular pressure (IOP) of more than 21 mmHg (between 10 am and 12 pm), glaucomatous damage on visual field or optic disc, and taking a maximum tolerated dose of IOP-lowering medication. INTERVENTION: Unilateral trabeculectomy with subconjunctival injection of bevacizumab (0.05 ml, 1.25 mg) adjacent to the bleb using a 30-gauge needle and tuberculin syringe administered immediately after trabeculectomy. MAIN OUTCOME MEASURES: Treatment success (unmedicated IOP of 6 to 16 mmHg inclusive) at 6 months; bleb characteristics according to the Moorfields bleb grading system on days 1, 7, 30, 90, and 180; incidence of postoperative intervention with 5-fluorouracil or mitomycin C; bleb needling; and incidence of and time to surgical failure. RESULTS: Mean age was 54.6+/-13.6 years. The mean preoperative IOP was 24.4+/-7.1 mmHg (range, 12-44 mmHg) and the patients were taking an average of 2.7+/-1.6 IOP-lowering medications (range, 1-4). The mean postoperative IOP was 8+/-3.1 mmHg (range, 4-13 mmHg) on day 1, 9.4+/-2.7 mmHg (range, 6-14 mmHg) on day 7, 10.9+/-2.8 mmHg (range, 8-16 mmHg) at 1 month, 10.3+/-2.5 mmHg (range, 7-14 mmHg) at 3 months, and 11.6+/-2.2 mmHg (range, 8-14 mmHg) at 6 months follow-up with no IOP-lowering medications. Preoperative best-corrected visual acuity was 0.70+/-0.3, whereas at 6 months after trabeculectomy, it was 0.66+/-0.3 (P = 0.39). After a mean follow-up of 182 days, of the 12 eyes, a successful trabeculectomy with respect to IOP control was observed in 11 eyes (92%), with an average IOP reduction of 52%. CONCLUSIONS: In this pilot study with a small number of subjects, 6-month outcomes suggest that subconjunctival bevacizumab is a potential adjunctive treatment for reducing the incidence of bleb failure after trabeculectomy. FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any materials discussed in this article.

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Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

December 2008

Volume

115

Issue

12

Start / End Page

2141 / 2145.e2

Location

United States

Related Subject Headings

  • Wound Healing
  • Visual Fields
  • Visual Acuity
  • Vascular Endothelial Growth Factor A
  • Trabeculectomy
  • Prospective Studies
  • Postoperative Complications
  • Pilot Projects
  • Ophthalmology & Optometry
  • Middle Aged
 

Citation

APA
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ICMJE
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Grewal, D. S., Jain, R., Kumar, H., & Grewal, S. P. S. (2008). Evaluation of subconjunctival bevacizumab as an adjunct to trabeculectomy a pilot study. Ophthalmology, 115(12), 2141-2145.e2. https://doi.org/10.1016/j.ophtha.2008.06.009
Grewal, Dilraj S., Rajeev Jain, Harsh Kumar, and Satinder Pal Singh Grewal. “Evaluation of subconjunctival bevacizumab as an adjunct to trabeculectomy a pilot study.Ophthalmology 115, no. 12 (December 2008): 2141-2145.e2. https://doi.org/10.1016/j.ophtha.2008.06.009.
Grewal DS, Jain R, Kumar H, Grewal SPS. Evaluation of subconjunctival bevacizumab as an adjunct to trabeculectomy a pilot study. Ophthalmology. 2008 Dec;115(12):2141-2145.e2.
Grewal, Dilraj S., et al. “Evaluation of subconjunctival bevacizumab as an adjunct to trabeculectomy a pilot study.Ophthalmology, vol. 115, no. 12, Dec. 2008, pp. 2141-2145.e2. Pubmed, doi:10.1016/j.ophtha.2008.06.009.
Grewal DS, Jain R, Kumar H, Grewal SPS. Evaluation of subconjunctival bevacizumab as an adjunct to trabeculectomy a pilot study. Ophthalmology. 2008 Dec;115(12):2141-2145.e2.
Journal cover image

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

December 2008

Volume

115

Issue

12

Start / End Page

2141 / 2145.e2

Location

United States

Related Subject Headings

  • Wound Healing
  • Visual Fields
  • Visual Acuity
  • Vascular Endothelial Growth Factor A
  • Trabeculectomy
  • Prospective Studies
  • Postoperative Complications
  • Pilot Projects
  • Ophthalmology & Optometry
  • Middle Aged