RT Journal Article
SR Electronic
T1 Trabeculectomy with mitomycin C alone or coupled with intracamerular bevacizumab? A 2-year comparative study
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP bjophthalmol-2021-319039
DO 10.1136/bjophthalmol-2021-319039
A1 Patrícia José
A1 Filipa Jorge Teixeira
A1 Rafael Barão
A1 David Cordeiro Sousa
A1 Raquel Esteves Marques
A1 Andre Diogo De Oliveira Barata
A1 Carlos Marques-Neves
A1 Marta Alves
A1 Ana Luísa Papoila
A1 Ingeborg Stalmans
A1 José Pedro Silva
A1 Luis Abegão Pinto
YR 2021
UL http://bjo.bmj.com/content/early/2021/04/29/bjophthalmol-2021-319039.abstract
AB Purpose To compare outcomes of primary trabeculectomy using either mitomycin C (MMC) alone versus MMC augmented with intracamerular bevacizumab in patients with open-angle glaucoma.Methods Retrospective, cohort, two-centre, comparative study. Patients’ data were screened between October 2015 and March 2019, with inclusion requiring a minimum follow-up of 24 months. Primary outcome was intraocular pressure (IOP) lowering at 24 months, with surgical success defined with different maximum IOP targets (≤18, ≤16 and ≤14 mm Hg) and at least 30% reduction and higher than 5 mm Hg. Absolute success was achieved if no IOP-lowering medication was needed and a qualified success if otherwise. Safety outcomes were analysed.Results A total of 110 eyes underwent trabeculectomy with MMC, 51 of these combined with intracamerular bevacizumab. Both strategies were effective in terms of IOP lowering (baseline vs 2 years postoperatively: 24.4 (8.0) mm Hg vs 12.1 (5.3) mm Hg in the MMC group; 25.1 (8.7) vs 10.8 (3.8) mm Hg in the MMC+bevacizumab group; p<0.001 in both comparisons). The MMC+bevacizumab group had a significant difference towards higher efficacy on absolute success rates at all targets (IOP≤14 or ≤16 or ≤18 mm Hg; p=0.010, p=0.039 and p=0.007, respectively). The large majority (93%) of the MMC+bevacizumab group was drop-free at 24 months, and 41% had IOP below 10 mm Hg. Complication rates were low and similar between groups, with no systemic adverse events.Conclusions Intracamerular bevacizumab in MMC-augmented primary trabeculectomy increases the chances of obtaining low IOP outcomes. This strategy may be useful when planning for surgeries aiming at target pressures in the low teens.Trial registration number ISRCTN93098069.Data are available in a public, open access repository.