title: Randomized controlled trial of subconjunctival bevacizumab injection in impending recurrent pterygium: a pilot study.
abstract: OBJECTIVE
  To investigate the efficacy and safety of subconjunctival bevacizumab injection for the treatment of impending recurrent pterygium.
  
  
  METHODS
  A prospective, randomized, single-masked, controlled trial was conducted in 80 patients with impending recurrent pterygium. Patients were randomized into 4 groups using random tables: 20 patients served as a control and treatment groups received a single intralesional injection of 1.25 mg (20 patients, group 1), 2.5 mg (20 patients, group 2), or 3.75 mg (20 patients, group 3) of bevacizumab. Topical 0.1% fluorometholone and ocular lubricant were administered 4 times daily for 1 month in all groups. Severity of impending recurrent pterygium graded by photographic assessment (at baseline, 3 days, 1 week, and 2, 4, 8, and 12 weeks after treatment) and true recurrence were the main outcome measures.
  
  
  RESULTS
  At 3 days, the conjunctival injection significantly decreased in all treatment groups (P < 0.01). A significant decrease in the conjunctival injection was still observed until 2 and 4 weeks in only groups 2 and 3, respectively (P < 0.05). The conjunctival hyperemia appeared to increase back to baseline at later time points. No significant difference in the mean severity score among the groups was observed. True recurrence was found in 62 patients with no statistically significant difference among the groups. No serious ocular or systemic adverse events were seen.
  
  
  CONCLUSIONS
  A single subconjunctival bevacizumab injection seems to only partially and transiently decrease conjunctival vascularization in impending recurrent pterygium in a dose-dependent manner. This treatment does not cause regression or reduce the recurrent rate of impending recurrent pterygium.
authors.affiliation: Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. lekhanont@yahoo.com
authors.forename: Kaevalin
authors.initials: K
authors.lastname: Lekhanont
authors.forename: Thanikan
authors.initials: T
authors.lastname: Patarakittam
authors.forename: Prakairut
authors.initials: P
authors.lastname: Thongphiew
authors.forename: Olan
authors.initials: O
authors.lastname: Suwan-apichon
authors.forename: Prut
authors.initials: P
authors.lastname: Hanutsaha
mesh_terms: D060433:Administration, Ophthalmic; D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D003228:Conjunctiva; D005260:Female; D005469:Fluorometholone / Q000008:administration & dosage; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D015552:Injections, Intralesional; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011625:Pterygium / Q000188:drug therapy* / Q000503:physiopathology; D012008:Recurrence; D016037:Single-Blind Method; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D005938:Glucocorticoids; D000068258:Bevacizumab; D005469:Fluorometholone