title: Randomized, controlled trial of conjunctival autografting combined with subconjunctival bevacizumab for primary pterygium treatment: 1-year follow-up.
abstract: BACKGROUND
  To investigate the efficacy and safety of subconjunctival bevacizumab application as an adjuvant therapy for primary pterygium.
  
  
  METHODS
  This study was a clinical randomized trial performed at the Institute of Ophthalmology 'Conde de Valenciana'.
  
  
  METHODS
  Forty-nine patients with primary pterygium were enrolled in the study.
  
  
  METHODS
  Each primary pterygium patient was randomized after pterygium excision and a conjunctival autograft to receive either a single 2.5 mg/0.1 mL dose of subconjunctival bevacizumab immediately after surgery (group 1); a double 2.5 mg/0.1 mL injection of subconjunctival bevacizumab, one immediately after surgery and the second 15 days after surgery (group 2); or no injection (group 3).
  
  
  METHODS
  Autoconjunctival graft presence or absence of ischaemia, necrosis, infection or detachment; surgical bed appearance; and pterygium recurrence at 1-year follow-up period were determined.
  
  
  RESULTS
  Forty-nine eyes of 49 patients were included. Sixteen patients were assigned to group 1, 17 to group 2 and 16 to group 3. Patients from groups 1 and 2 showed conjunctival autograft ischaemia at 24 h postoperative (37.5% and 58.8%, respectively, P > 0.05), which disappeared by the first postoperative month. No significant difference in the main outcome measures was found among single versus double-dose of subconjunctival bevacizumab injection patients. At the end of the study, pterygium recurrences were observed only in group 3 (P < 0.04).
  
  
  CONCLUSIONS
  A single 2.5 mg/mL subconjunctival bevacizumab injection in conjunction with primary pterygium surgery accomplishing a conjunctival autograft procedure is safe and well tolerated, and is capable of preventing pterygium recurrences when compared with a control group.
authors.affiliation: Research Unit, Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico; Oculoplastics Department, Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico.
authors.forename: Angel
authors.initials: A
authors.lastname: Nava-Castañeda
authors.forename: Osiris
authors.initials: O
authors.lastname: Olvera-Morales
authors.forename: Cynthia
authors.initials: C
authors.lastname: Ramos-Castellon
authors.forename: Lilia
authors.initials: L
authors.lastname: Garnica-Hayashi
authors.forename: Yonathan
authors.initials: Y
authors.lastname: Garfias
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000627:therapeutic use*; D000068258:Bevacizumab; D003131:Combined Modality Therapy; D003228:Conjunctiva / Q000098:blood supply / Q000637:transplantation*; D005260:Female; D006801:Humans; D056965:Injections, Intraocular; D007511:Ischemia / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011625:Pterygium / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D055502:Secondary Prevention; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab
keywords: clinical trial; conjunctival allograft; pterygium; subconjunctival bevacizumab