Journal Article

Intracameral bevacizumab as an adjunct to trabeculectomy: a 1-year prospective, randomised study

Zeyen, Thierry, Van Bergen, Tine, Abegão Pinto, Luís, Vandewalle, Evelien, Spielberg, Leigh, Spileers, Werner, Moons, Lieve, Fieuws, Steffen, Stalmans, Ingeborg

2014

Overview

Aims To investigate the efficacy and safety of a single intracameral bevacizumab injection to improve the outcome of trabeculectomy. Methods A 12-month, prospective, randomised, double-masked, placebo-controlled trial. Patients with medically uncontrolled open-angle glaucoma scheduled for a primary trabeculectomy were recruited and randomised to receive 50 µL of either bevacizumab (1.25 mg) or placebo (balanced salt solution) peroperatively. Absolute success was defined as intraocular pressure (IOP) ≤18 mm Hg and >5 mm Hg with at least 30% reduction from baseline and no loss of light perception. Success through the use of additional medical and/or surgical IOP-lowering treatments was defined as qualified success. Results 138 patients completed a 12-month follow-up, 69 of whom were in the bevacizumab treated group. IOP at 1 year postoperatively was significantly lower than baseline (placebo: 25.6±9.9 mm Hg vs 11.5±3.9 mm Hg, p<0.01; bevacizumab: 24.8±8.1 mm Hg vs 11.9±3.8 mm Hg, p<0.01), with no difference between treatment groups (p=0.69). However, absolute success was higher in the bevacizumab group (71% vs 51%, p=0.02), with the need for IOP-lowering interventions (needlings) being lower in this group (12% vs 33%, p=0.003). Complication rates were low and comparable between groups. Conclusions Peroperative administration of intracameral bevacizumab significantly reduces the need for additional interventions during the follow-up of patients undergoing trabeculectomy.

• Publisher: BMJ Publishing Group LTD
• Subject: Aged / Angiogenesis Inhibitors - administration & dosage / Angiogenesis Inhibitors - adverse effects / Antibodies, Monoclonal, Humanized - administration & dosage / Antibodies, Monoclonal, Humanized - adverse effects / Bevacizumab / Chemotherapy, Adjuvant / Diabetic retinopathy / Disease / Double-Blind Method / Female / Fibroblasts / Glaucoma / Glaucoma, Open-Angle - drug therapy / Glaucoma, Open-Angle - surgery / Heart attacks / Hospitals / Humans / Kaplan-Meier Estimate / Male / Middle Aged / Pharmacists / Prospective Studies / Studies / Surgery / Surgical outcomes / Time Factors / Trabeculectomy / Vascular endothelial growth factor / Viscoelasticity / Wound healing