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Post-trabeculectomy topical bevacizumab preventing bleb failure: a preliminary study

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Journal of Ocular Biology, Diseases, and Informatics

Abstract

This study aims to evaluate the efficacy and safety of post-trabeculectomy topical bevacizumab, in preventing bleb failure. A total of 11 females and 12 males were enrolled for the study. After a complete ophthalmic evaluation, the patients underwent trabeculectomy. Full ophthalmic examination was done the next day, which included visual acuity, intraocular pressure (IOP), and bleb morphology. Next, two drops of bevacizumab [0.25 mg (0.01 ml)] were instilled over the wound area with a tuberculin (1 ml) syringe. Pressure was applied at the medial canthus to prevent it from going into the lacrimal passage. Similar postoperative procedures were repeated at 1, 2, 3, and 4 weeks. So in all, five instillations of bevacizumab were completed. Later, the patients were followed at 1-month interval for 6 months. Target IOP was achieved in all eyes and was maintained during the study period of 6 months without any anti-glaucoma medication. Average IOP before trabeculectomy was 27.27 ± 8.92 mmHg, which decreased postoperatively to 8.77 ± 0.97 mmHg at 3 months and 9.27 ± 1.16 mmHg at 6 months. This drop in IOP was statistically significant on both occasions (p = 0.00). A nice low filtering bleb was formed after the surgery, and it remained the same during the study period. The other parameters like cup-to-disc ratio and visual field did not change during the 6 months of study as expected because glaucoma is a slow progressive disease. Modulating the wound at multiple sites by bevacizumab (inflammation, proliferative, and remodeling stages) can lead to success of trabeculectomy.

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Authors and Affiliations

  1. King George’s Medical University, Lucknow, Uttar Pradesh, India

    Shashi Kumar Bhasker, Sandeep Saxena & Kamlesh Singh

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  1. Shashi Kumar Bhasker
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  2. Sandeep Saxena
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  3. Kamlesh Singh
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Correspondence to Shashi Kumar Bhasker.

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Bhasker, S.K., Saxena, S. & Singh, K. Post-trabeculectomy topical bevacizumab preventing bleb failure: a preliminary study. j ocul biol dis inform 5, 89–95 (2012). https://doi.org/10.1007/s12177-013-9108-3

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  • DOI: https://doi.org/10.1007/s12177-013-9108-3

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