Preliminary Results of Subconjunctival Bevacizumab in Primary Pterygium Excision

Abstract

Purpose: To evaluate the efficacy of subconjunctival bevacizumab as an adjunctive therapy for primary pterygium surgery. Material and Methods: This randomized prospective clinical study was conducted on 30 eyes of 30 patients. After pterygium excision and accomplishing a rotational conjunctival flap, 15 patients (case group) received 1.25 mg (0.1 ml) bevacizumab, and 15 other patients (control group) received 0.1 ml balanced salt solution subconjunctivally. The main outcome measures were recurrence of pterygia, horizontal length of the corneal epithelial defect, conjunctival erythema, lacrimation and photophobia during the first postoperative week. Results: There were no statistically significant differences regarding age, sex or recurrence risk factors between the two groups (p > 0.05). The pterygia resolved in 13 (86.6%) of 15 eyes in both groups, with a recurrence rate of 13.4% during a mean follow-up period of 8 ± 1.4 months in the case group and 7.4 ± 1.5 months in the control group (p = 0.2). There were no statistically significant differences regarding reduction in refractive astigmatism, improvement in visual acuity, corneal epithelial defects, conjunctival erythema, lacrimation or photophobia between the case and control groups (p > 0.05). Conclusions: A single intraoperative subconjunctival bevacizumab injection had no effect on recurrence rate or early postoperative conjunctival erythema, lacrimation, photophobia or healing of corneal epithelial defects following pterygium excision.

Prevention of Recurrent Pterygium with Topical Bevacizumab 0.05% Eye Drops: A Randomized Controlled Trial

“…Two randomized controlled trials, 12,13 1 case series, 14 and 1 case report, 15 found that subconjunctival bevacizumab reduced the symptoms and sizes of pterygia, but the effect was temporary and not clinically relevant. [12][13][14][15] Furthermore, Razeghinejad et al 16 and Shenasi et al 17 reported that subconjunctival bevacizumab used as an adjunctive therapy after primary pterygial surgery did not significantly prevent recurrence of pterygia, even though the treatment was well tolerated. The reason for this may be because of the short-term temporary effect of the drug.…”

Sutureless amniotic membrane transplantation combined with narrow-strip conjunctival autograft for pterygium

“…The surgical methods for pterygium consist of the use of CAT, limbal and limbal-conjunctival transplantation, conjunctival flap and conjunctival rotation surgery, AMT, cultivated conjunctival transplantation, lamellar keratoplasty and use of fibrin glue. The medical methods include mitomycin C treatment, 5-fluorouracil and beta-irradiation, and use of anti-vascular endothelial growth factor [6][7][8][9].…”

Bevacizumab and Ocular Wound Healing After Primary Pterygium Excision

“…Conjunctival erythema was scored as 1 for moderate and 2 for severe. 6 Conjunctival flap edema, subconjunctival hemorrhage, lacrimation, and photophobia were scored as either 0, indicating absence, or 1, for presence. Any complications of conjunctival flaps such as retraction or melting and wound infection were recorded.…”

“…12 In our previous report, subconjunctival bevacizumab (1.25 mg) caused a clinically but not statistically significant amount of corneal epithelial defect in patients who underwent pterygium excision. 6 In this study, we report the effect of a higher dose of bevacizumab with greater participants on the early postoperative wound healing after pterygium excision.…”

“…4,5 To prevent the recurrence of pterygium after excision, various adjunctive measures including bevacizumab have been employed. 6,7 Bevacizumab (Avastin) is a recombinant humanized murine monoclonal antibody that binds to and inhibits the biological activities of all human vascular endothelial growth factor A (VEGF-A) isoforms. Bevacizumab is the first VEGF inhibitor approved by the U.S. Food and Drug Administration for systemic use in cancer, but its use for ocular diseases has not yet been approved.…”