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Intracameral bevacizumab as an adjunct to trabeculectomy: a 1-year prospective, randomised study
  1. Evelien Vandewalle1,
  2. Luís Abegão Pinto2,3,
  3. Tine Van Bergen4,
  4. Leigh Spielberg5,
  5. Steffen Fieuws6,
  6. Lieve Moons7,
  7. Werner Spileers1,
  8. Thierry Zeyen1,
  9. Ingeborg Stalmans1,4
  1. 1Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
  2. 2Department of Pharmacology and Neurosciences of Faculty of Medicine of Lisbon University, Lisbon, Portugal
  3. 3Department of Ophthalmology, Centro Hospitalar Lisboa Central, Lisbon, Portugal
  4. 4Laboratory of Ophthalmology, Katholieke Universiteit Leuven, Leuven, Belgium
  5. 5Department of Ophthalmology, Rotterdam Eye Hospital, Rotterdam, The Netherlands
  6. 6I-Biostat, Katholieke Universiteit Leuven, Belgium
  7. 7Department of Animal physiology and Neurobiology, Katholieke Universiteit Leuven, Leuven, Belgium
  1. Correspondence to Professor I Stalmans, Department of Ophthalmology, University Hospitals Leuven, Campus St Raphaël, Kapucijnenvoer 33, Leuven B-3000, Belgium; ingeborg.stalmans{at}uzleuven.be

Abstract

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.

  • Wound healing
  • Clinical Trial
  • Glaucoma

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