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Volkan Hurmeric, Pravin K. Vaddavalli, Anat Galor, Sonia H. Yoo, Victor L. Perez; The Effect Of Single And Multiple Injections Of Subconjunctival Ranibizumab In Patients With Recurrent Pterygium. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4026.
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To compare the effect of single and multiple injections of subconjunctival ranibizumab injection in patients with recurrent pterygium.
Prospective, open label, pilot study in a single-center, academic practice. Nine eyes of nine patients were recruited into two groups. The first group included five patients who recieved a single subconjunctival injection of 0.5 mg of ranibizumab. The second group included four patients who received multiple (7.5 ± 2.5 injections) subconjunctival 0.5 mg ranibizumab injections. All subconjunctival ranibizumab (0.5 mg/0.05 ml) injections were administered at the limbus, adjacent to the head of the recurrent pterygium. Patients were followed prospectively for 6 months. The main outcome measures were safety and efficacy of subconjunctival ranibizumab injections on the conjunctival hyperemia and the extent of the corneal neovascularization.
In group one, a transient decrease of the conjunctival hyperemia was noted in all patients on post-injection day 1. An increase in corneal neovascularization was noted in 4 patients; in 2 patients at 1 month, and in another 2, at the 6 month time point. Stabilization of corneal neovascularization was noted in one patient. In group two, all patients demonstrated a decrease in the area of corneal neovascularization, two to eight weeks after the first injection. At sixth months,controls one patient had 34% decrease and 4 patients had 32 ± 23 % increase in the area of neovascularization. The two patients who demonstrated significant decrease on the area of corneal neovascularization after subconjunctival ranibizumab injections had a relatively small size of pterygium recurrence.
Our data suggest that one injection of ranibizumab in recurrent pterygium transiently decreases conjunctival hyperemia but does not have a sustained effect on corneal neovascularization. Multiple injections demonstrate a transient decrease in the area of neovascularization in the first month of the treatment. Subconjunctival ranibizumab injections seem to be effective in reducing neovascularization in patients with minimal or early recurrent pterygia.
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