Document Detail


Safety and efficacy of using off-label bevacizumab versus mitomycin C to prevent bleb failure in a single-site phacotrabeculectomy by a randomized controlled clinical trial.
MedLine Citation:
PMID:  21543993     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To analyze the safety and efficacy of bevacizumab (1.25 mg/0.05 mL) versus 0.03% mitomycin C (MMC) for preventing bleb failure in patients undergoing single-site phacotrabeculectomy for primary open-angle glaucoma or chronic angle-closure glaucoma.
MATERIALS AND METHODS: Thirty-eight consecutive patients with visually significant cataract and coexistent primary open-angle glaucoma or chronic angle-closure glaucoma were randomized into 3 groups. One group received conventional 0.03% MMC (n=13); the second group received 3 subconjunctival injections of bevacizumab (1.25 mg in 0.05 mL) (n=13); and the third group received bevacizumab soaked in sponges (1.25 mg in 0.05 mL) (n=12) intraoperatively on the sclera. Patients were followed up for 6 months. The primary outcome measure was treatment success and bleb morphology in the study eye at 6-month follow-up.
RESULTS: All 3 groups showed significant reduction in mean intraocular pressure at 1 week after treatment, which was maintained at 6 months. However, the subconjunctival bevacizumab group had 90% patients with complete success as opposed to 60% in each of the other 2 groups (P=0.04). In both bevacizumab groups, bleb vascularity increased progressively over the 6-month follow-up. One patient in the subconjunctival bevacizumab group showed a local conjunctival necrosis.
CONCLUSION: In this pilot study with a small number of subjects, short-term outcomes suggest that subconjunctival bevacizumab is equally effective in reducing intraocular pressure with a better safety profile compared with MMC in the dosing schedule studied. However, bevacizumab soaked in a sponge appears to have no advantages over MMC. Subconjunctival bevacizumab may be a useful agent for improving success and for limiting scar tissue after phacotrabeculectomy.
Authors:
Sabyasachi Sengupta; Rengaraj Venkatesh; Ravilla D Ravindran
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of glaucoma     Volume:  21     ISSN:  1536-481X     ISO Abbreviation:  J. Glaucoma     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-03     Completed Date:  2012-12-07     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  9300903     Medline TA:  J Glaucoma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  450-9     Citation Subset:  IM    
Affiliation:
Glaucoma Services, Aravind Eye Hospital, Pondicherry, India. drsunny1980@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Alkylating Agents / administration & dosage*,  adverse effects
Angiogenesis Inhibitors / administration & dosage*,  adverse effects
Antibodies, Monoclonal, Humanized / administration & dosage*,  adverse effects
Cataract / complications
Chronic Disease
Combined Modality Therapy
Conjunctiva / drug effects*
Female
Glaucoma, Angle-Closure / complications,  surgery
Glaucoma, Open-Angle / complications,  surgery
Humans
Intraocular Pressure / physiology
Male
Middle Aged
Mitomycin / administration & dosage*,  adverse effects
Off-Label Use
Phacoemulsification*
Pilot Projects
Tonometry, Ocular
Trabeculectomy*
Treatment Failure
Treatment Outcome
Wound Healing / drug effects
Chemical
Reg. No./Substance:
0/Alkylating Agents; 0/Angiogenesis Inhibitors; 0/Antibodies, Monoclonal, Humanized; 2S9ZZM9Q9V/bevacizumab; 50-07-7/Mitomycin
Comments/Corrections
Comment In:
J Glaucoma. 2013 Mar;22(3):266   [PMID:  23429635 ]
J Glaucoma. 2013 Mar;22(3):266-7   [PMID:  23429624 ]

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


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