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C. R. Hilgert, A. H. Hilgert, A. N. Odashiro, J. D. Pena, C. L. Lottemberg, A. Paranhos, Jr.; Anti Scarring Effect of Intraoperative Bevacizumab and Mitomycin C Alone and Combined on Glaucoma Filtration Surgery in the Rabbit. Invest. Ophthalmol. Vis. Sci. 2010;51(13):625.
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To determine the effects of bevacizumab and mitomycin (MMC) alone and combined on intraocular pressure (IOP) and scarring process after glaucoma filtration surgery (GFS) on rabbits.
This is a randomized, prospective, masked-observer study. Thirty New Zealand white rabbits underwent modified GFS and were allocated into three groups regarding the medications used during the surgery: subconjunctival bevacizumab (25mg/ml - 0.05 ml) alone (Group A); bevacizumab combined with MMC (0.2mg/ml) (Group B) and MMC alone (Group C). IOPs were measured using Tonopen on immediate preoperative period and on postoperative days 8, 14, 17, 21 and 30 under general anesthesia (Xylazin 2% and Ketamin 50 mg/ml). The rabbits were killed 30 days after the surgery. Scarring process was addressed by tissue section using Masson and Picrosirius stains on bleb area.
There was a statistically significant difference on IOP measurements during the follow up (postoperative days 8, 14 and 17). Group A had higher IOP level than B and C (P<0.01). Group B had lower IOP than Group C, but this difference did not reach statistical significance ( P>0.05) (ANOVA for repeated measure). Regarding scarring process the results were similar: Group A had the highest level of fibrosis compared to groups B and C ( P>0.05) ( Kruskal Wallis ANOVA).
The results showed that bevacizumab alone was not as good as associated with MMC or even MMC alone, regarding scarring process modulation on trabeculectomy in the rabbit. Both drugs associated had lower IOP means and less fibrosis formation but it was not statistically significant when compared to MMC alone.
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