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Frederick M Kapetansky; Injection of Bevacizumab at the time of Molteno-3 tube insertion: a pilot study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3153.
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To investigate whether a single intraoperative injection of bevacizumab (anti-Vascular Endothelial Growth Factor) has a beneficial effect on the postoperative intraocular pressure (IOP) following the insertion of a Molteno-3 (M3) aqueous drainage device.
With the appropriate informed consent 19 patients (19 eyes) had a Molteno-3 (185 mm2) tube inserted for uncontrolled open angle glaucoma. A 3o prolene suture was passed into the lumen of the tube, and an 8-0 vicryl suture was tied around the tube in order to occlude totally the lumen. A second group (17 patients, 19 eyes) had an identical procedure with the addition of a sub-conjunctival injection over the plate at the time of the initial surgery of bevacizumab (SCB) 1.25 mg. The IOP was measured in both groups at pre-op, 3, 6, 9, and 12 months
Baseline IOP for (SCB) group was 22.8 + 8.5 mm Hg and for the control group 27.2 + 10.6 mm Hg. The (SCB) group at one month had the only statisitically significant mean IOP. (P=0.06) 12.4 + 5.4 vs. 16.0 + 5.5 mm Hg. Final IOP (12 months) for (SCB) was 11.2 + 4.0 vs. the control eyes 13.7 + 3.8 mm Hg (P=0.34).
SCB produced a statistically significant reduction in IOP for the first thirty days following M3 insertion. The one year follow up IOP, although it was lower for SCB (11.2 + 4.0 vs.14.7 + 3.8 mm Hg), was not statistically significant (P=0.34). Future investigation should include more than one postoperative injection of SCB.
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