title: Subconjunctival bevacizumab versus mitomycin C adjunctive to trabeculectomy.
abstract: OBJECTIVE
  To compare the outcome of trabeculectomy with subconjunctival bevacizumab with that of trabeculectomy with mitomycin C (MMC).
  
  
  METHODS
  Prospective, randomized, comparative study.
  
  
  METHODS
  Thirty-six eyes from 34 patients with uncontrolled glaucoma were enrolled. Eighteen eyes underwent trabeculectomy with subconjunctival bevacizumab injection (2.5 mg/0.1 mL), and 18 eyes underwent trabeculectomy with MMC (0.02% for 3 minutes). The outcome measures were the best-corrected visual acuity, intraocular pressure (IOP), number of IOP-lowering medications, complications, and bleb morphologic features (based on the Indiana Bleb Appearance Grading Scale).
  
  
  RESULTS
  The mean follow-up times for the MMC and bevacizumab groups were 7.8 ± 2.2 months and 7.4 ± 24 months, respectively (P = .62). The mean preoperative IOP in the bevacizumab group improved from 21.9 ± 7.9 mm Hg with 2.7 ± 0.8 antiglaucoma medications to 13.6 ± 3.2 mm Hg with 0.2 ± 0.5 antiglaucoma medications at the last visit (P < .001 and P < .001, respectively). The mean preoperative IOP in the MMC group improved from 23.3 ± 4.9 mm Hg with 2.6 ± 0.7 antiglaucoma medications to 9.6 ± 2.7 mm Hg with no antiglaucoma medications at the final visit (P < .001 and P < .001, respectively). There was a statistically significant difference in the IOP between the 2 groups at the last visit (P < .001). The cumulative probabilities of total success at the last follow-up according to Kaplan-Meier analysis were 100% and 94.4% in bevacizumab and MMC groups, respectively (P = .32, log-rank test).
  
  
  CONCLUSIONS
  Adjunctive subconjunctival bevacizumab with trabeculectomy is effective in controlling the IOP profile; however, its effect is less prominent than that of MMC.
authors: Ophthalmic Research Center, Rassoul Akram Hospital, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran. naveednil@yahoo.com
authors: Naveed
authors: N
authors: Nilforushan
authors: Maryam
authors: M
authors: Yadgari
authors: Shahin Khosh
authors: SK
authors: Kish
authors: Nariman
authors: N
authors: Nassiri
mesh_terms: D000477:Alkylating Agents / Q000627:therapeutic use*; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D017024:Chemotherapy, Adjuvant; D003228:Conjunctiva; D017889:Exfoliation Syndrome / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D011446:Prospective Studies; D014130:Trabeculectomy; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000477:Alkylating Agents; D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D016685:Mitomycin