title: [Comparison study on the efficacy and safety of bevacizumab versus mitomycin C as adjuvants in trabeculectomy].
abstract: OBJECTIVE
  The objective of this study is to compare the efficacy and safety of bevacizumab versus mitomycin C as an adjuvant anti-scarring agent in Trabeculectomy.
  
  
  METHODS
  A prospective, comparative, non-randomized, interventional study was conducted on a case series. A total of 49 eyes of 45 patients with uncontrolled glaucoma were recruited: 22 eyes in the bevacizumab (BVZ) group, and 27 eyes in the mitomycin C (MMC) group. Complete success was defined as intraocular pressure (IOP) less than 18 mmHg without any antiglaucoma medications. Follow-up visits were made on 1, 7, 30, 90 and 180 days after the surgery. Visual acuity, mean IOP, number of antiglaucoma medications and additional procedures to control IOP were recorded at each follow up visit. Local and systemic complications were also noted.
  
  
  RESULTS
  At the end of the follow-up there were no significant differences in mean IOP between groups: mean IOP was 13.4 ± 3.5mmHg (range 8-20) in the BVZ group and 11.6 ± 2.6 mmHg (range 7-17) in the MMC group (P=.08). Complete success was achieved in 77.2% (17 out of 22) in the BVZ group and 96.2% (26 out of 27) in the MMC group, which was a statistically significant difference (P=.024). More patients required antiglaucoma medications to control IOP in the BVZ group at the end of the study: 0.36 ± 0.72 medications versus 0.03 ± 0.19 medications in the MMC group (P=.018). Three patients developed avascular cystic blebs in the BVZ group. None of the patients suffered any ocular or systemic complications related to the use of these agents.
  
  
  CONCLUSIONS
  Bevacizumab could be a safe and effective anti-scarring agent; however IOP reduction appears to be greater with MMC, and also less antiglaucoma medications are needed with this anti-scarring agent. Bevacizumab could favor the formation of avascular cystic blebs.
authors.affiliation: Departamento de Glaucoma, Servicio de Oftalmología, Hospital Universitario de Fuenlabrada, Madrid, España. Electronic address: emgiral@hotmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Martín Giral
authors.affiliation: Departamento de Glaucoma, Servicio de Oftalmología, Hospital Universitario de Fuenlabrada, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Rivera Zori
authors.affiliation: Departamento de Glaucoma, Servicio de Oftalmología, Hospital Universitario de Fuenlabrada, Madrid, España.
authors.forename: S
authors.initials: S
authors.lastname: Perucho Martínez
authors.affiliation: Departamento de Glaucoma, Servicio de Oftalmología, Hospital Universitario de Fuenlabrada, Madrid, España.
authors.forename: N
authors.initials: N
authors.lastname: Toledano Fernández
mesh_terms: D000368:Aged; D000068258:Bevacizumab / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D005901:Glaucoma / Q000628:therapy*; D006801:Humans; D008297:Male; D016685:Mitomycin / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D014130:Trabeculectomy; D016896:Treatment Outcome
chemical_list: D000068258:Bevacizumab; D016685:Mitomycin
keywords: Bevacizumab; Fibrosis; Mitomicina C; Mitomycin C; Trabeculectomy; Trabeculectomía; Wound healing