Role of Subconjunctival Bevacizumab in Post-Pterygium Excision Management

Abstract

 

Purpose

 

The exact pathogenesis of pterygium formation is unknown, but previous research has demonstrated that various growth factors, including VEGF, may play a role. The use of VEGF inhibitors bevacizumab and ranibizumab is poorly understood in inhibiting pterygium growth. The objective of this study was to compare the effects of wound healing and recurrence rates in postoperative bevacizumab versus pterygium excision alone.

 

Methods

 

This was a prospective trial. Thirty-one patients with a primary pterygium of at least 2 mm in size and without any previous ocular surgery were included. Seventeen patients received 5mg postoperative bevacizumab on postoperative weeks two and six, while fourteen patients received no bevacizumab. Outcome measures included best corrected visual acuity, intraocular pressure, recurrence, and any sight threatening complications at two weeks, two months, and six months postoperatively.

 

Results

 

Six patients were lost to follow-up, four of which were assigned to the bevacizumab group. Of the remaining thirteen patients in the bevacizumab group, four had recurrence of the pterygium (30.7%). Two of the remaining twelve in the control group had a recurrence (16.7%).

 

Conclusions

 

Bevacizumab does not improve recurrence rates for pterygia when used as an adjunctive therapy postoperatively. It may even cause increased rates of recurrence, although further studies are needed before arriving at this conclusion.

 

 

Figure 1. A. Preoperative photograph of a 4mm nasal pterygium of the left eye. B. Recurrence of pterygium 2 months after surgery in a patient who received postoperative bevacizumab.

 

 

Figure 1. A. Preoperative photograph of a 4mm nasal pterygium of the left eye. B. Recurrence of pterygium 2 months after surgery in a patient who received postoperative bevacizumab.

 

Keywords: 479 cornea: clinical science