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J. Jung, H. Choi, J. Lee, H. Park, J. Lee; Effect of Bevacizumab on Strabismus Surgery in Rabbits. Invest. Ophthalmol. Vis. Sci. 2010;51(13):16.
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This study was intended to evaluate the effect of Bevacizumab on the postoperative inflammation and adhesion following strabismus surgery in rabbits.
A prospective, masked and controlled trial was conducted. Fifteen New Zealand white rabbits were used for this study. Both eyes of 15 rabbits underwent reinsertion of superior rectus muscle (SRM). Right eye of each animal was received subconjunctival Bevacizumab injection (0.1ml). As control, the contralateral eyes were treated with subconjunctival normal saline injection (0.1ml). After 1 day, the SRM were assessed for change in acute inflammation by immunohistochemical localization of macrophage and monocyte using anti-CD11, an antibody specific for these cell types. Four weeks later, the extraocular muscle reattachments sites of control and treated eyes were compared to process adhesion scoring and histological examination. Adhesion severities were scored from 0 to 3 according to criteria, when 0= no adhesion, 1-firmly adhesion easily separated with blunt dissection, 2=mild to moderate adhesion with freely dissectible plane, 3= moderate to dense adhesion with difficult dissection or non dissectible plane. In the histopathologic observation, the degree of inflammatory cell infiltration and global muscle change were evaluated. Nonparametric statistical analysis was performed by the Wilcoxon rank sum test, a p-value less than 0.05 being accepted as statically significant.
Cross-section through SRM of rabbits stained for the presence of CD11-positive cells 1 day after injection demonstrated that inflammatory cell infiltration was reduced in Bevacizumab injection group. Four weeks after injection, the adhesion scores between two groups were statically insignificant (p=0.93). Histopathological findings revealed that muscle change and fibrosis of treated eyes were no significant difference compared to the control eyes.
Even though, our data do not support the hypothesis that Avastin® would be effective in reducing post operative scarring after strabismus operation in rabbits, Avastin® may be available option to reduce inflammatory response. The effects of repeated exposure and the half-life of bevacizumab in the extraocular muscle and surrounding connective tissue have been unknown; therefore, further studies are required to evaluate the repeated usage and long term application of Avastin®. On the other hand, combination with anti metabolite, such as MMC or 5-FU would be applicable to prevent post operative scar formation.
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