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Subconjunctival bevacizumab versus mitomycin C adjunctive to trabeculectomy
Naveed Nilforushan1, Maryam Yadgari, Shahin Khosh Kish
1Ophthalmic Research Center, Rassoul Akram Hospital, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran. naveednil@yahoo.com
American Journal of Ophthalmology
|October 11, 2011
Summary
Subconjunctival bevacizumab with trabeculectomy effectively lowers intraocular pressure (IOP) in glaucoma patients. However, mitomycin C (MMC) demonstrated a more pronounced IOP-lowering effect in this comparative study.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Vascular Endothelial Growth Factor Inhibitors
Background:
- Glaucoma management often requires surgical intervention to reduce intraocular pressure (IOP).
- Trabeculectomy is a common glaucoma surgery, with adjunctive medications used to enhance outcomes.
- Mitomycin C (MMC) is a frequently used antifibrotic agent in trabeculectomy.
Purpose of the Study:
- To compare the efficacy and safety of subconjunctival bevacizumab versus MMC as adjunctive treatments in trabeculectomy for uncontrolled glaucoma.
Main Methods:
- A prospective, randomized, comparative study involving 36 eyes of 34 patients with uncontrolled glaucoma.
- Eighteen eyes received trabeculectomy with subconjunctival bevacizumab (2.5 mg).
- Eighteen eyes received trabeculectomy with MMC (0.02% for 3 minutes).
- Outcomes assessed included best-corrected visual acuity, IOP, medication use, complications, and bleb morphology.
Main Results:
- Both bevacizumab and MMC groups showed significant IOP reduction and decreased medication needs (P < .001).
- The MMC group achieved a lower final mean IOP (9.6 ± 2.7 mm Hg) compared to the bevacizumab group (13.6 ± 3.2 mm Hg) (P < .001).
- Cumulative success rates were high in both groups (100% for bevacizumab, 94.4% for MMC), with no significant difference (P = .32).
Conclusions:
- Adjunctive subconjunctival bevacizumab is effective in controlling IOP after trabeculectomy.
- Mitomycin C (MMC) appears to provide a more significant IOP-lowering effect compared to bevacizumab in this study.
- Further research may explore optimal dosing or combination strategies for bevacizumab in glaucoma surgery.
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