Journal List > J Korean Ophthalmol Soc > v.54(1) > 1009634

Suh and Choi: The Effect of Subconjunctival Bevacizumab Injection after Primary Pterygium Surgery

Abstract

Purpose

To evaluate the effect and safety of subconjunctival bevacizumab injection immediately after primary pterygium surgery.

Methods

From October 2010 to June 2011, 54 patients (54 eyes) with primary pterygium who had received pterygium excision with the bare sclera technique were evaluated. Twenty-seven patients (27 eyes) in the bevacizumab group received a subconjunctival injection of 5 mg (0.2 ml) bevacizumab and 27 patients (27 eyes) in the control group received a subconjunctival injection of 0.2 ml balanced salt solution immediately after surgery. At the 6-month follow-up, the degree of fibrovascular tissue proliferation, the recurrence rate of pterygium and the effect of wound healing were analyzed prospectively.

Results

One month after the surgery, the degree of fibrovascular tissue proliferation was inhibited in the bevacizumab group compared to the control group (p = 0.028). However, 3 to 6 months after surgery, there was no significant difference between the 2 groups. In addition, there was no significant difference between the 2 groups in the recurrence rate of pterygium and wound healing after surgery.

Conclusions

Subconjunctival bevacizumab injection after primary pterygium surgery inhibited the degree of fibrovascular tissue proliferation for 1 month and safe for wound healing. Subconjunctival bevacizumab injection has the potential for adjunctive therapy after pterygium surgery.

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Figure 1.
(A) Bevacizumab group, preoperative appearance. (B) Bevacizumab group, One month after surgery. The proliferation of fibrovascular tissue is inhibited (grade 0). (C) Control group, preoperative appearance. (D) Control group, One month after surgery. The proliferation of fibrovascular tissue is found (grade 1).
jkos-54-53f1.tif
Table 1.
Demographic characteristics of the patients
  Bevacizumab group Control group p-value
Number 27 27  
Sex (M/F) 25/2 21/6 0.129
Eye (R/L) 12/15 16/11 0.280
Age (yrs) 68.6 ± 7.7 67.1 ± 9.0 0.579
Horizontal pterygium size (mm) 3.0 ± 0.9 2.7 ± 0.8 0.461

Values are presented as mean ± SD.

M/F = male/female; R/L = right/left.

Table 2.
Postoperative courses in the bevacizumab group and control group
Variables Bevacizumab group Control group p-value
Horizontal length of corneal epithelial defect (mm)      
   1st day 1.56 ± 0.67 1.31 ± 0.72 0.256
   1 wk 0.08 ± 0.18 0.06 ± 0.14 0.909
   1 mon 0 0
Photopobia (n)      
   1st day 6 8 0.538
   1 wk 5 4 0.718
   1 mon 1 0
Lacrimation (n)      
   1st day 15 12 0.424
   1 wk 6 7 0.756
   1 mon 1 1 1
Subconjunctival hemorrhage (n)      
   1st day 3 1 0.303
   1 wk 2 1 0.556
   1 mon 0 0
Corneal endothelial cell      
Preoperative 2484.3 ± 346.3 2492.6 ± 357.0 0.910
   1 mon 2474.7 ± 321.3 2468.3 ± 406.5 0.653

Values are presented as mean ± SD.

Table 3.
Postoperative fibrovascular proliferation grade
  Bevacizumab group (n) Control group (n) p-value
Postoperative 1 wk      
   Grade 0 27 27  
   Grade 1* 0 0 1
   Grade 2* 0 0  
Postoperative 1 mon      
   Grade 0 20 12  
   Grade 1 7 15 0.028
   Grade 2* 0 0  
Postoperative 3 mons      
   Grade 0 10 9  
   Grade 1 15 17 0.996
   Grade 2* 2 1  
Postoperative 6 mons      
   Grade 0 7 5  
   Grade 1 14 14 0.437
   Grade 2* 6 8  

* Define as pterygium recurrence.

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