Post-trabeculectomy topical bevacizumab preventing bleb failure: a preliminary study

• Published in: Journal of ocular biology, diseases, and informatics diseases, and informatics, 2012-12, Vol.5 (3-4), p.89-95
• Main Authors: Bhasker, Shashi Kumar, Saxena, Sandeep, Singh, Kamlesh
• Format: Article
• Language: English
• Subjects: Health Informatics; Medicinal Chemistry; Medicine; Medicine & Public Health; Neurobiology; Neurochemistry; Neurology; Ophthalmology
• ISSN: 1936-8437; 1936-8445; 1936-8445
• DOI: 10.1007/s12177-013-9108-3

This study aims to evaluate the efficacy and safety of post-trabeculectomy topical bevacizumab, in preventing bleb failure. A total of 11 females and 12 males were enrolled for the study. After a complete ophthalmic evaluation, the patients underwent trabeculectomy. Full ophthalmic examination was done the next day, which included visual acuity, intraocular pressure (IOP), and bleb morphology. Next, two drops of bevacizumab [0.25 mg (0.01 ml)] were instilled over the wound area with a tuberculin (1 ml) syringe. Pressure was applied at the medial canthus to prevent it from going into the lacrimal passage. Similar postoperative procedures were repeated at 1, 2, 3, and 4 weeks. So in all, five instillations of bevacizumab were completed. Later, the patients were followed at 1-month interval for 6 months. Target IOP was achieved in all eyes and was maintained during the study period of 6 months without any anti-glaucoma medication. Average IOP before trabeculectomy was 27.27 ± 8.92 mmHg, which decreased postoperatively to 8.77 ± 0.97 mmHg at 3 months and 9.27 ± 1.16 mmHg at 6 months. This drop in IOP was statistically significant on both occasions ( p  = 0.00). A nice low filtering bleb was formed after the surgery, and it remained the same during the study period. The other parameters like cup-to-disc ratio and visual field did not change during the 6 months of study as expected because glaucoma is a slow progressive disease. Modulating the wound at multiple sites by bevacizumab (inflammation, proliferative, and remodeling stages) can lead to success of trabeculectomy.