Intracameral bevacizumab as an adjunct to trabeculectomy: a 1-year prospective, randomised study

Evelien Vandewalle, Luís Abegão Pinto, Tine Van Bergen, Leigh Spielberg, Steffen Fieuws, Lieve Moons, Werner Spileers, Thierry Zeyen, Ingeborg Stalmans

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    AIMS: To investigate the efficacy and safety of a single intracameral bevacizumab injection to improve the outcome of trabeculectomy.

    METHODS: A 12-month, prospective, randomised, double-masked, placebo-controlled trial. Patients with medically uncontrolled open-angle glaucoma scheduled for a primary trabeculectomy were recruited and randomised to receive 50 µL of either bevacizumab (1.25 mg) or placebo (balanced salt solution) peroperatively. Absolute success was defined as intraocular pressure (IOP) ≤18 mm Hg and >5 mm Hg with at least 30% reduction from baseline and no loss of light perception. Success through the use of additional medical and/or surgical IOP-lowering treatments was defined as qualified success.

    RESULTS: 138 patients completed a 12-month follow-up, 69 of whom were in the bevacizumab treated group. IOP at 1 year postoperatively was significantly lower than baseline (placebo: 25.6±9.9 mm Hg vs 11.5±3.9 mm Hg, p<0.01; bevacizumab: 24.8±8.1 mm Hg vs 11.9±3.8 mm Hg, p<0.01), with no difference between treatment groups (p=0.69). However, absolute success was higher in the bevacizumab group (71% vs 51%, p=0.02), with the need for IOP-lowering interventions (needlings) being lower in this group (12% vs 33%, p=0.003). Complication rates were low and comparable between groups.

    CONCLUSIONS: Peroperative administration of intracameral bevacizumab significantly reduces the need for additional interventions during the follow-up of patients undergoing trabeculectomy.

    Original languageEnglish
    Pages (from-to)73-8
    Number of pages6
    JournalBritish Journal of Ophthalmology
    Volume98
    Issue number1
    DOIs
    Publication statusPublished - Jan 2014

    Keywords

    • Aged
    • Angiogenesis Inhibitors/administration & dosage
    • Antibodies, Monoclonal, Humanized/administration & dosage
    • Bevacizumab
    • Chemotherapy, Adjuvant
    • Double-Blind Method
    • Female
    • Glaucoma, Open-Angle/drug therapy
    • Humans
    • Kaplan-Meier Estimate
    • Male
    • Middle Aged
    • Prospective Studies
    • Time Factors
    • Trabeculectomy

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