title: Prospective study comparing mitomycin C or bevacizumab as adjuvant in trabeculectomy revision by needling.
abstract: OBJECTIVE
  To compare the use of mitomycin C (MMC) or bevacizumab (BEV) as adjunctive in the needling revision of failed trabeculectomy blebs.
  
  
  METHODS
  Glaucoma patients with failed trabeculectomy were included. Cystic blebs were excluded. All procedures were performed by the same surgeon at the operating room under peribulbar blockade. Rate of success, intraocular pressure (IOP), and number of antiglaucoma drugs in use were compared before and after the procedures. The IOP was measured postoperatively at days 1, 30, 90, and 180. Absolute success was defined as IOP ≤18 mm Hg, without any complication or use of any antiglaucomatous drugs. Qualified success was the same criteria, but with the use of any antiglaucomatous drugs.
  
  
  RESULTS
  Twenty-nine eyes of 29 patients were included: 15 eyes with MMC and 14 eyes with BEV. There was no statistical difference in the IOP reduction between the groups (MMC 32.6 ± 16.1% vs BEV 30.1 ± 12.0%, p = 0.6). The BEV group showed similar reduction in the number of antiglaucoma drugs compared to the MMC group (p = 0.6). Absolute success was found in 28.5% of the BEV group and in 6.6% of patients with MMC. Qualified success was found in 64.3% and 73.4%, respectively, both limited to 180 days.
  
  
  CONCLUSIONS
  In this selected and limited group of patients, bevacizumab can be considered as an alternative to MMC in the needling revision of failed trabeculectomy. Studies with a larger number of patients and longer follow-up are needed to confirm the hypothesis suggested here.
authors.affiliation: Ophthalmology Department (CEROF/UFG), Federal University of Goiás, Goiânia - Brazil.
authors.forename: Leiser
authors.initials: L
authors.lastname: Franco
authors.affiliation: Ophthalmology Department (CEROF/UFG), Federal University of Goiás, Goiânia - Brazil.
authors.forename: Bruna
authors.initials: B
authors.lastname: Rassi
authors.affiliation: Ophthalmology Department (CEROF/UFG), Federal University of Goiás, Goiânia - Brazil.
authors.forename: Marcos P
authors.initials: MP
authors.lastname: Avila
authors.affiliation: Ophthalmology Department (CEROF/UFG), Federal University of Goiás, Goiânia - Brazil.
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Magacho
mesh_terms: D000368:Aged; D000477:Alkylating Agents / Q000627:therapeutic use*; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D005260:Female; D005901:Glaucoma / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D009339:Needles; D011446:Prospective Studies; D012086:Reoperation; D014065:Tonometry, Ocular; D014129:Trabecular Meshwork / Q000601:surgery; D014130:Trabeculectomy / Q000379:methods*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D000477:Alkylating Agents; D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D016685:Mitomycin