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Evelien Vandewalle, Thierry Zeyen, Tine Van Bergen, Leigh Spielberg, Werner Spileers, Ingeborg Stalmans; One year results of intracameral bevacizumab as an adjunct to trabeculectomy in open angle glaucoma patients. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2137.
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To investigate the effect of a single intracameral administration of bevacizumab (Avastin®) in terms of clinical outcome following trabeculectomy in patients with either primary open-angle glaucoma (POAG) or normal tension glaucoma (NTG).
Between April 2009 and November 2010, 144 consecutive, medically uncontrolled glaucoma patients who were scheduled for primary trabeculectomy were included in this prospective, randomized, double-blinded and placebo-controlled study. Patients were divided into POAG and NTG groups, which were then randomized to receive 50 µl of either bevacizumab (25 mg/ml) or placebo (balanced salt solution) in the anterior chamber peroperatively. Patients with NTG also received mitomycin C. The target intraocular pressure (IOP) range was between 6 and 18 mmHg for POAG and between 6 and 14 mmHg for NTG patients. Absolute success was defined as meeting the target IOP without IOP-lowering medications or postoperative interventions. Qualified success was defined as meeting the target IOP with or without either IOP-lowering medications and/or postoperative surgical interventions.
138 out of 144 randomized patients reached the 1 year follow-up timepoint, 69 of whom received bevacizumab and 69 received placebo. Absolute success in the bevacizumab group was 71% compared to 51% in the placebo group (p=0.02). Qualified success was 87% in the bevacizumab group versus 86% in the placebo group (p=0.99). Needlings were significantly less frequent in the bevacizumab group compared to the placebo group, respectively in 13% versus 35% (p=0.003). Complication rates were low and comparable in both groups.
A single intracameral administration of bevacizumab at the end of trabeculectomy was associated with increased absolute success rates and reduced need for postoperative interventions in order to reach the target IOP.
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