Document Detail


Bleb vascularity following post-trabeculectomy subconjunctival bevacizumab: a pilot study.
MedLine Citation:
PMID:  22429268     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background:  To determine whether postoperative subconjunctival bevacizumab significantly alters bleb vascularity. Design:  A randomised, prospective interventional study. Participants:  43 eyes from 39 patients were recruited, with 21 eyes randomised to subconjunctival injections of 5-FU, and 22 eyes to combined 5-FU/bevacizumab. Methods:  All patients who underwent uncomplicated primary anti-metabolite augmented trabeculectomy who subsequently required post-operative subconjunctival 5-Fluorouracil (5-FU) injection within 4 weeks of surgery were eligible. Patients were randomised to receive subconjunctival 5-FU only (7.5mg/0.15ml) or 5 FU plus bevacizumab (1.25mg/0.05ml). Main Outcome Measures:  Primary outcome was bleb vascularity with secondary endpoints including visual acuity (VA), intraocular pressure (IOP), bleb morphology, complications and total numbers of 5-FU injections were recorded at baseline, week 12 and 18 months. Results:  At week 12, there was no significant difference between groups for VA, IOP, bleb vascularity and morphology or total number of 5-FU injections. By 18 months, 47.4% of the 5-FU/bevacizumab group exhibited central bleb avascularity compared to 21.1% of the 5 FU group (Fisher exact test, p = 0.17). 2 bleb complications (1 blebitis; 1 suture abscess) recorded in the 5 FU/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 suggest the need for a larger clinical trial to further evaluate the safety and efficacy of bevacizumab as a modulating agent in glaucoma filtration surgery. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.
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     Date:  2012-3-19
Journal Detail:
Title:  Clinical & experimental ophthalmology     Volume:  -     ISSN:  1442-9071     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896531     Medline TA:  Clin Experiment Ophthalmol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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, Australia and Royal Victorian Eye & Ear Hospital, Melbourne, Australia Ophthalmology Department, Wellington Hospital, Capital & Coast District Health Board, Wellington, New Zealand Dr. Rajendra Prasad Centre for Ophthalmic Sciences, India Singapore National Eye Centre, Singapore.
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