Johnny Wu
Curtin University, Australia
Title: A prospective, randomized trial comparing the use of post-operative adjunctive Bevacizumab vs placebo in primary Trabeculectomy surgery for glaucoma
Biography
Biography: Johnny Wu
Abstract
Purpose: To compare the effectiveness of postoperative adjunctive use of subconjunctival Bevacizumab in altering the outcome of primary trabeculectomy in terms of sustained lowering of Intraocular Pressure (IOP), reduction in postoperative bleb vascularization and fibrosis and need for glaucoma medications and 5-Fluorouracil (5-FU) needling.
Methods: A single centre, prospective, randomized control trial for patients with uncontrolled IOP under maximal medical treatment. A primary trabeculectomy with Mitomycin-C (MMC) was done and the patients were randomized to either post operative subconjunctival injection of Bevacizumab (1.25 mg/0.05 ml) or Balanced Salt Solution (BSS). A minimum follow up period of one year was included.
Results: Of the fifty-nine patients (59 eyes), 47 (80%) completed at least one year of follow up, where there was no significant difference between the two groups for Humphrey visual field indexes, IOP (p=0.65), bleb morphology (p=0.65), need for glaucoma medications (p=0.65) or 5-FU needling (p=0.11).
Conclusion: No statistically significant differences in IOP were found at one year between the two groups. The bleb morphology was optimal in more patients in the Bevacizumab group; however it was not statistically significant and not related to a lower IOP. The Bevacizumab group had a higher rate of success results and a lower use of glaucoma medications after surgery; however it required more 5-FU needling procedures. None of these differences were statistically significant. A larger sample size is needed to determine whether the differences found between the treatment groups are statistically significant and to investigate potential optimal dose and frequency responses for this possible addition to our armamentarium in glaucoma surgery.