Intracameral Bevacizumab as an Adjunct to Trabeculectomy: a 1-Year Prospective, Randomised Study

• Autor(a) principal: Vandewalle, E
• Data de Publicação: 2014
• Outros Autores: Abegão Pinto, L, Bergen, T, Spielberg, L, Fieuws, S, Moons, L, Spileers, W, Zeyen, T, Stalmans, I
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.17/3807
• topic: HSAC OFT; Aged; Angiogenesis Inhibitors / administration & dosage; Angiogenesis Inhibitors / adverse effects; Antibodies, Monoclonal, Humanized / administration & dosage; Antibodies, Monoclonal, Humanized / adverse effects; Bevacizumab; Chemotherapy, Adjuvant; Female; Double-Blind Method; Male; Glaucoma, Open-Angle / drug therapy; Glaucoma, Open-Angle / surgery; Humans; Kaplan-Meier Estimate; Middle Aged; Prospective Studies; Time Factors; Trabeculectomy

Aims: To investigate the efficacy and safety of a single intracameral bevacizumab injection to improve the outcome of trabeculectomy. Methods: A 12-month, prospective, randomised, double-masked, placebo-controlled trial. Patients with medically uncontrolled open-angle glaucoma scheduled for a primary trabeculectomy were recruited and randomised to receive 50 µL of either bevacizumab (1.25 mg) or placebo (balanced salt solution) peroperatively. Absolute success was defined as intraocular pressure (IOP) ≤18 mm Hg and >5 mm Hg with at least 30% reduction from baseline and no loss of light perception. Success through the use of additional medical and/or surgical IOP-lowering treatments was defined as qualified success. Results: 138 patients completed a 12-month follow-up, 69 of whom were in the bevacizumab treated group. IOP at 1 year postoperatively was significantly lower than baseline (placebo: 25.6±9.9 mm Hg vs 11.5±3.9 mm Hg, p<0.01; bevacizumab: 24.8±8.1 mm Hg vs 11.9±3.8 mm Hg, p<0.01), with no difference between treatment groups (p=0.69). However, absolute success was higher in the bevacizumab group (71% vs 51%, p=0.02), with the need for IOP-lowering interventions (needlings) being lower in this group (12% vs 33%, p=0.003). Complication rates were low and comparable between groups. Conclusions: Peroperative administration of intracameral bevacizumab significantly reduces the need for additional interventions during the follow-up of patients undergoing trabeculectomy.