Document Detail


Bleb vascularity following post-trabeculectomy subconjunctival bevacizumab: a pilot study.
MedLine Citation:
PMID:  22429268     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Brian E Chua; Dan Q Nguyen; Queena Qin; Jonathan B Ruddle; Anthony P Wells; Nuwan Niyadurupola; Viney Gupta; Tina T Wong; Michael A Coote; Jonathan G Crowston
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-06-04
Journal Detail:
Title:  Clinical & experimental ophthalmology     Volume:  40     ISSN:  1442-9071     ISO Abbreviation:  Clin. Experiment. Ophthalmol.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-08     Completed Date:  2013-03-17     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  100896531     Medline TA:  Clin Experiment Ophthalmol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  773-9     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.
Affiliation:
Centre for Eye Research Australia, Department of Ophthalmology, University of Melbourne, and Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiogenesis Inhibitors / therapeutic use*
Antibodies, Monoclonal, Humanized / therapeutic use*
Antimetabolites / therapeutic use*
Conjunctiva / drug effects
Drug Therapy, Combination
Female
Fluorouracil / therapeutic use*
Glaucoma / surgery*
Humans
Injections
Intraocular Pressure / physiology
Male
Middle Aged
Pilot Projects
Prospective Studies
Surgical Flaps / blood supply*
Tonometry, Ocular
Trabeculectomy*
Vascular Endothelial Growth Factor A / antagonists & inhibitors
Visual Acuity / physiology
Wound Healing / drug effects
Chemical
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Antibodies, Monoclonal, Humanized; 0/Antimetabolites; 0/VEGFA protein, human; 0/Vascular Endothelial Growth Factor A; 2S9ZZM9Q9V/bevacizumab; 51-21-8/Fluorouracil
Comments/Corrections
Comment In:
Clin Experiment Ophthalmol. 2012 Nov;40(8):769-70   [PMID:  23134427 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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