title: Subconjunctival bevacizumab as an adjuvant in first-time filtration surgery for patients with primary glaucomas.
abstract: To investigate subconjunctival bevacizumab as an adjuvant in first-time glaucoma filtration surgery, we conducted a non-comparative, interventional case series, enrolling consecutive patients with uncontrolled primary glaucomas. All patients underwent trabeculectomy with mitomycin C and received a 1.25 mg subconjunctival bevacizumab injection at completion of the surgery. Main outcome measurements were success rates, bleb morphology [standardized classification based on vascularity (0-1), extension (0-1) and height (0-1); ranging from 0 to 3 (0 = poor; 1 = regular; 2 = good; 3 = excellent)] and post-operative complications. Twenty-five eyes from 25 patients (mean age 64.3 ± 12.8 years) were included. After a mean follow-up of 16.7 ± 6.1 months, mean intraocular pressure (IOP) was significantly reduced from 22.7 ± 10.8 to 12.9 ± 4.3 mmHg at the last follow-up (p < 0.01). Complete success rates at 12 months ranged between 71 and 88 %, while qualified success rates ranged between 84 and 96 %, depending on the criterion adopted (the strictest success criterion was defined as IOP between 6 and 12 mmHg). Blebs were graded as good or excellent in 80 % of the cases. No serious post-operative complication or avascular blebs were observed. These mid-term results suggest subconjunctival bevacizumab as a safe and effective adjuvant in first-time filtration surgery for primary glaucoma patients.
authors: Glaucoma Service, Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 820, Vila Clementino, São Paulo, Brazil.
authors: Luis Gustavo
authors: LG
authors: Biteli
authors: Tiago Santos
authors: TS
authors: Prata
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005901:Glaucoma / Q000628:therapy*; D006801:Humans; D056965:Injections, Intraocular; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use; D011446:Prospective Studies; D014130:Trabeculectomy / Q000379:methods*
chemical_list: D020533:Angiogenesis Inhibitors; D000903:Antibiotics, Antineoplastic; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D016685:Mitomycin
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