title: Intracameral bevacizumab as an adjunct to trabeculectomy: a 1-year prospective, randomised study.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Ophthalmology, University Hospitals Leuven, , Leuven, Belgium.
authors.forename: Evelien
authors.initials: E
authors.lastname: Vandewalle
authors.forename: Luís
authors.initials: L
authors.lastname: Abegão Pinto
authors.forename: Tine
authors.initials: T
authors.lastname: Van Bergen
authors.forename: Leigh
authors.initials: L
authors.lastname: Spielberg
authors.forename: Steffen
authors.initials: S
authors.lastname: Fieuws
authors.forename: Lieve
authors.initials: L
authors.lastname: Moons
authors.forename: Werner
authors.initials: W
authors.lastname: Spileers
authors.forename: Thierry
authors.initials: T
authors.lastname: Zeyen
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Stalmans
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000009:adverse effects; D000068258:Bevacizumab; D017024:Chemotherapy, Adjuvant; D004311:Double-Blind Method; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D014130:Trabeculectomy
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab
keywords: Clinical Trial; Glaucoma; Wound healing