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Luis G. Biteli, Sr., Pilar d. Moreno, Gabriela C. Barreto, Augusto Paranhos, Tiago S. Prata, Sr.; Subconjunctival Bevacizumab as Adjuvant in Primary Glaucoma Surgery: Short-term Follow-up. Invest. Ophthalmol. Vis. Sci. 2011;52(14):639.
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To report the short-term outcomes of a surgical technique using subconjunctival bevacizumab as adjuvant in first-time surgery for primary open-angle glaucoma (POAG) or chronic angle-closure glaucoma (CACG).
Noncomparative, interventional case series in which consecutive primary glaucoma patients (POAG and CACG) underwent glaucoma surgery with subconjunctival application of bevacizumab. Each patient underwent standard trabeculectomy with mitomycin C [combined (group II) or not (group I) with phacoemulsification and intraocular lens implantation], and received a 1.25 mg of subconjunctival bevacizumab injection at completion of the surgery. Preoperative and postoperative IOP, number of antiglaucoma medications, best-corrected visual acuity, filtering bleb morphology, surgical complications, and any subsequent related events or procedures were recorded. Bleb morphology was evaluated using a standardized system based on vascularity, extension and height [grades: from 0 (worst) to 3 (best)].
A total of 36 eyes from 36 patients (mean age, 68.4+/-9.8 years) were included in the study. Twenty-one patients had open-angle glaucoma and fifteen had angle-closure glaucoma. Mean follow-up was 8.5+/-3.4 months in group I and 4.6+/-2.7 months in group II. Mean IOP was significantly reduced from 22.3+/-7.3 to 10.5+/-2.8 mm Hg at the last follow-up visit in group I and from 19.9+/-6.4 to 10.6+/-2.7 mm Hg in group II (P<0.0001). The mean number of antiglaucoma medications was significantly reduced from 3.1+/-0.58 to 0.3+/-0.7 in group I and from 3+/-0.9 to 0.3+/-0.6 in group II (P<0.0001). Out of the 36 eyes, 29 (80.5%) had bleb morphology graded ³2. Complete (6<IOP<18mmHg without medication) and qualified success (6<IOP<18mmHg with medication) rates were 85 % and 15 % in group I, and 68,8% and 31.2% in group II. Needling was required in 3 eyes of each group. No serious postoperative complication was observed, and none of the eyes presented with avascular bleb at last follow-up visit.
Our findings suggest that using subconjunctival bevacizumab as adjuvant in in first-time surgery for primary glaucoma is an effective alternative for glaucoma management with minor postoperative complications.
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