title: Efficacy of sub-conjunctival and topical bevacizumab in high-risk corneal transplant survival.
abstract: OBJECTIVE
  To evaluate the effectiveness of subconjunctival bevacizumab and topical bevacizumab in preventing neovascularisation on high-risk corneal grafts.
  
  
  METHODS
  The randomised, controlled, parallel group study was carried out from February 2008 to April 2012 at Isra Postgraduate Institute of Ophthalmology and Yasin Eye Hospital, Karachi. Eyes with high-risk corneal transplantation with corneal neovascularisation were included in the trial. Patients were randomly allocated to 3 groups: A, B and C. After penetrating keratoplasty, Group A patients received subconjunctival bevacizumab (2.5 mg/ 0.1 ml), Group B, patients received sham injection, while Group C patients received topical bevacizumab (2.5%, 25 mg/ml). lt was self-administered 4 times a day for 24 weeks. Group B was the control group. Corneal neovascular invasion area was measured using mathematical software programme Mat Lab. Data analyses were done using SPSS version 19.
  
  
  RESULTS
  Of the total 122 patients, there were 41 (33.88%) each in Group A and B, while Group C had 40 (32.78%) patients. Among the 3 groups, mean corneal neovascular invasion area was minimum in Group A (n = 3; 6.23%), while in Group B it was 12.3% (n = 5). Group C had the maximum corneal neovascular invasion area after 24 weks (n = 11; 26.7%). Maximum number of patients (n = 36; 87.80%) attained visual acuity of 6/36 or better in Group Afollowed by Group C (n = 26; 65%) and Group B (n = 17; 41.46%).
  
  
  CONCLUSIONS
  Subconjunctival bevacizumab reduces the recurrence of neovascularisation and, thus, helps increasing the frequency of graft survival in cases of high-risk corneal transplants. When used topically, it is less effective.
authors.affiliation: Department of Ophthalmology, Isra Postgraduate Institute of Ophthalmology, Karachi. nasirbhatti_dr@yahoo.com
authors.forename: Nasir
authors.initials: N
authors.lastname: Bhatti
authors.affiliation: Department of Ophthalmology, Isra Postgraduate Institute of Ophthalmology, Karachi.
authors.forename: Umair
authors.initials: U
authors.lastname: Qidwai
authors.affiliation: Department of Ophthalmology, Isra Postgraduate Institute of Ophthalmology, Karachi.
authors.forename: Munawar
authors.initials: M
authors.lastname: Hussain
authors.affiliation: Department of Ophthalmology, Isra Postgraduate Institute of Ophthalmology, Karachi.
authors.forename: Asif
authors.initials: A
authors.lastname: Kazi
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D005260:Female; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D056965:Injections, Intraocular; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab