Intraoperative Subconjunctival Bevacizumab as an Adjunctive Treatment in Primary Pterygium: A Preliminary Report

Shahin, Maha; Elbendary, Amal M.; Elwan, Mohamed

doi:10.3928/15428877-20120802-02

Cited by 29 publications

(14 citation statements)

References 37 publications

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“…In contrast to our study and most of the previous studies on the use of bivacizumab in pterygium surgery, Maha et al31 and Mohamed et al32 found that a subconjunctival injection of 1.25 mg/0.05 mL of bevacizumab at the end of the surgery did not result in a statistically significant difference in the recurrence rates or postoperative conjunctival erythema with discomfort, lacrimation, photophobia, or healing of corneal epithelial defects after pterygium excision.…”

Section: Discussioncontrasting

confidence: 99%

Preoperative subconjunctival combined injection of bevacizumab and mitomycin C before the surgical excision of primary pterygium: clinical and histological results

Alsmman¹,

Radwan²,

Abozaid³

et al. 2017

OPTH

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PurposeThe aim of this study was to detect the clinical and histological effects of preoperative subconjunctival injection of both bevacizumab and mitomycin C (MMC) 1 month before the surgical excision of primary pterygium using a bare sclera technique.Patients and methodsA total of 20 patients with primary pterygium underwent subconjunctival combined injection of 0.1 mL of MMC (0.1 mg/mL) and 0.1 mL of bevacizumab (1.25 mg/0.1 mL) 1 month before bare sclera excision of the pterygium. The excised pterygium tissues were examined histologically and immunohistologically by CD31 staining, and the patients were followed up clinically for at least 2 years. The excised pterygia of two patients without preoperative injection were used for histological comparison.ResultsClinically, there were no intraoperative or postoperative complications. No recurrence was noted during the follow-up period. Histologically, the previously injected pterygia showed a decreased number of epithelial cells and stromal fibroblasts. The latter were rounded or oval and swollen rather than spindle shaped, and some were degenerating or apoptotic. Collagen and elastic fibers were degenerated, distorted, and decreased in density, while blood capillaries were obliterated. There was a significant decrease in CD31-positive cells in previously injected pterygia.ConclusionPreoperative subpterygium combined injection of bevacizumab and MMC is safe and effective in reducing the postoperative recurrence of primary pterygium. Histological and immunohistological changes in the form of decreased fibrovascular activity and degeneration of the extracellular matrix and nerve axons were noted.

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Section: Discussioncontrasting

confidence: 99%

Preoperative subconjunctival combined injection of bevacizumab and mitomycin C before the surgical excision of primary pterygium: clinical and histological results

Alsmman¹,

Radwan²,

Abozaid³

et al. 2017

OPTH

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“…In the series by Shahin et al. (), two cases developed conjunctival autograft pallor 1 week following intra‐operative subconjunctival bevacizumab injection. One led to early recurrence, and the other led to a graft loss.…”

Section: Resultsmentioning

confidence: 99%

“…Shahin et al. () studied subconjunctival bevacizumab after conjunctivo‐limbal autograft and found the bevacizumab group had a higher recurrence rate compared to the control group (20% versus 9.5% respectively). In addition, the recurrence in the bevacizumab group occurred earlier and more aggressively, including two cases that exhibited conjunctivo‐limbal graft pallor and subsequent failure.…”

Section: Resultsmentioning

confidence: 99%

Use of anti‐vascular endothelial growth factor in the management of pterygium

Mak

Chan

Marcet

et al. 2016

Acta Ophthalmologica

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ABSTRACT.The rising success of anti-vascular endothelial growth factor (VEGF) therapies in ocular disease has stimulated the use of such treatments in the surgical management of pterygium. We reviewed the literature to better understand the safety and efficacy of the adjunctive role of anti-VEGF treatments for pterygium excision. Without surgery, anti-VEGF alone may favourably alter symptoms and vascularity, but does not cause pterygium regression. Some evidence supports the use of anti-VEGF as an adjuvant therapy to surgery, especially when using a higher dose and a more frequent dosing regimen. Overall, anti-VEGF is generally safe and well tolerated in patients with pterygium. Currently, the evidence does not conclusively support the use of anti-VEGF in pterygium surgery. However, further research may guide unanswered questions regarding the interaction between VEGF and other factors responsible for pterygium growth. In addition, the optimal route and dosage of anti-VEGF administration is not yet known.

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“…Nevertheless, the favorable effect was incomplete and temporary, similar to that reported by Leippi et al (25) . Previous reports suggesting the effective role of subconjunctival bevacizumab were noncomparative case reports (25,28,31) . Corneal neo vascularization was inhibited or regressed, but not completely elimi …”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of subconjunctival bevacizumab for recurrent pterygium

Stival¹,

Lago²,

Figueiredo³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Purpose: To evaluate the clinical outcome(s) and complication(s) of subcon junctival bevacizumab treatment in patients with recurrent pterygium. Methods: This prospective case series included patients who had undergone pterygium surgery and were diagnosed with recurrent pterygium. All patients received one subconjunctival injection of 0.5 mL of bevacizumab (2.5 mg/0.1 mL). The main outcome was the change in size and clinical appearance. The clinical appearance of the pterygium was graded according to Tan and colleagues. The horizontal size of the pterygium (from limbus to apex) was recorded from baseline to 2 months after injection. Treatmentrelated complications and adverse events were reported. Results: We included 36 eyes of 36 patients (18 males) with a mean age of 58.75 ± 10.98 years. Totally, 30.6% patients developed recurrent pterygium in both eyes (only the worst eye was treated), with 47.2% developing it in the left eye and 22.2% in the right eye. More than half the patients (58.3%) had a family history of pterygium. There was a significant difference in the size of pterygium at different intervals (P<0.05). Approximately twothirds (66.7%) of patients pre sented with hyposphagma on the 2 nd day after subconjunctival application; this value decreased to 30.6% by day 7 and to 0% at 1 month. Most patients (69.4%) ex hibited amelioration of irritative symptoms within 2 days, 88.9% after 7 days, and 97.2% after 1 month. Conclusions: Subconjunctival bevacizumab injection is useful for the manage ment of patients with recurrent pterygium, with no significant local or systemic adverse effects.

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Intraoperative Subconjunctival Bevacizumab as an Adjunctive Treatment in Primary Pterygium: A Preliminary Report

Abstract: Intraoperative subconjunctival bevacizumab following primary pterygium surgical excision is not helpful and possibly harmful. Larger studies are needed.

Cited by 29 publications

References 37 publications

Preoperative subconjunctival combined injection of bevacizumab and mitomycin C before the surgical excision of primary pterygium: clinical and histological results

Preoperative subconjunctival combined injection of bevacizumab and mitomycin C before the surgical excision of primary pterygium: clinical and histological results

Use of anti‐vascular endothelial growth factor in the management of pterygium

Efficacy and safety of subconjunctival bevacizumab for recurrent pterygium

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