Two Cases of Subconjunctival Bevacizumab Injection to Prevent Bleb Failure After Trabeculectomy

Dong Wook Lee; Dae-Gyu Lee

doi:10.3341/jkos.2008.49.8.1345

Journal List > J Korean Ophthalmol Soc > v.49(8) > 1008059

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Lee and Lee: Two Cases of Subconjunctival Bevacizumab Injection to Prevent Bleb Failure After Trabeculectomy

Original Article

J Korean Ophthalmol Soc 2008;49(8):1345-1349.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.8.1345

Two Cases of Subconjunctival Bevacizumab Injection to Prevent Bleb Failure After Trabeculectomy

Dong Wook Lee, M.D.¹, Dae-Gyu Lee, M.D.²

Department of Ophthalmology, Chonbuk National University, College of Medicine, Jeonju, Korea

Department of Ophthalmology, Cheju National University, College of Medicine, Jeju, Korea

Address reprint requests to Dae-Gyu Lee, M.D. Department of Ophthalmology, Cheju National University Hospital #154 Samdo-2-dong, jeju-city, jeju 690-719, Korea Tel: 82-64-750-1602, Fax: 82-64-750-1243, E-mail: ldg8621@naver.com

Received 1 August 2008 Accepted 30 June 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Angiogenesis is an integral part of wound healing, which is an unwanted process in the postoperative period after trabeculectomy. It was the aim of this study to report on the subconjunctival use of bevacizumab (Avastin^®) as an antiproliferative agent to augment trabeculectomy.

Case summary

This clinical interventional case study included 2 patients with secondary glaucoma associated with uveitis who underwent antiglaucomatous filtering surgery combined with a subconjunctival injection of bevacizumab. Limbal-based trabeculectomy was performed, and subconjunctival injections (1.25 mg/0.05 ml) were given at the end of the surgery adjacent to the bleb, which was raised using a single-use 26 gauge needle. At 1 and 2 weeks and 1, 3, and 6 months after surgery, intraocular pressure was reduced in both patients to 11 mmHg with functioning filtering blebs. No complications were observed.

Conclusions

The results suggest that subconjunctival bevacizumab injection may be helpful in reducing the risk of postoperative scarring of the filtering bleb.

Keywords: Bevacizumab (Avastin ®), Subconjunctival injection, Trabeculectomy

References

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Figure 1.

Case. (1a) Conjuntival filtering bleb at one day after bevacizumab injection; (1b) Anterior segment photograph at 1 month after surgery.

Figure 2.

Case 2. (2a) Anterior segment photograph at 1 month after surgery; (2b) Well functioning filtering bleb three months after trabeculectomy with subconjunctival bevacizumab injection.

Figure 3.

Intraocular pressure (IOP) changes following trabeculectomy with subconjunctival bevacizumab injection.

Table 1.

Patients’ characteristics and preoperative and postoperative intraocular pressure and best corrected visual acuity*

				Pre-operative	Post-operative	Post-operative
Case	Age/sex	Diagnosis	Pre-operative IOP	BCVA*	6 months IOP	6 months BCVA*
1	37/M	Posner-Schlossman syndrome	40 mmHg	0.1	11 mmHg	0.15
2	28/M	Behcet disease	28 mmHg	0.1	11 mmHg	0.1

^* BCVA=Best corrected visual acuity;

^† IOP=Intraocular pressure.

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