Postoperative subconjunctival bevacizumab injection as an adjunct to 5-fluorouracil in the management of scarring after trabeculectomy

Figures & data

Table 1 Baseline patient characteristics (n = 61)

Age, years (mean ± SD)	67 ± 9.7
Range, years	35–86
Sex, male/female, N	25/36
Follow-up, months (mean ± SD)	25 ± 19.1
Range, months	1–81
Eye, OD/OS, N	26/35
Previous surgeries, N (mean ± SD)	1 ± 1.0
Range	0–4
Previous argon laser trabeculoplasty, N (mean ± SD)	0.5 ± 0.6
Range	0–2
Glaucoma diagnosis, N
POWG	33
PEX	14
PDG	4
NTG	5
OHT	2
PACG	2
Applied intraoperative MMC, N
0.01%	2
0.02%	52
0.05%	7
Second operations, N (mean ± SD)	1 ± 1
Range	0–4
Laser suture lysis, N (mean ± SD)	1 ± 1.4
Range	0–7

Abbreviations: MMC, mitomycin C; N, number; NTG, normal tension glaucoma; OD, right eye; OHT, ocular hypertension; OS, left eye; PACG, primary angle closure glaucoma; PDG, pigment dispersion glaucoma; PEX, pseudoexfoliation glaucoma; POWG, primary open angle glaucoma; SD, standard deviation.

Figure 1 Intraocular pressure values preoperative to 12 months/last follow-up.

Table 2 Preoperative and postoperative comparisons

	5-FU group	5-FU and bevacizumab group	Total	P-value between groups
Antiglaucomatous medications, N (mean ± SD)
Preoperative	2.1 ± 1.0	2.5 ± 0.9	2.3 ± 1	0.121
Range	0–4	1–4	0–4
Postoperative	0.1 ± 0.4	0.2 ± 0.5	0.2 ± 0.5	0.434
Range	0–2	0–2	0–2
Preoperative lens status, N
Phakic	31	21	52	0.167
Pseudophakic	3	6	9
Lens status 12 months/last follow-up, N
Phakic	26	16	42	0.174
Pseudophakic	8	11	19
IOP, mmhg (mean ± SD, range)
Preoperative	24 ± 6 (15–37)	24 ± 6 (14–37)	24 ± 6 (14–37)	0.989
Postoperative	12 ± 2 (8–17)	11 ± 3 (6–16)	12 ± 3 (6–17)	0.380
BCVA, decimal
Preoperative	0.8	0.62		0.213
Postoperative	0.8	0.35		0.162
Visual field (MD ± SD, range)
Preoperative	7.5 ± 7 (−1.1 to 22.1)	10.5 ± 7.6 (0–23.9)	9 ± 7.3 (−1.1 to 23.9)	0.126
Postoperative	8.2 ± 6.3 (1.3–21.7)	12.0 ± 7.7 (0.9–24.0)	10 ± 7.1 (0.9–24)	0.106
Complete successa	78.79% (N = 26)	85.19% (N = 23)	81.67% (N = 49)	0.739
Complete successb	84.85% (N = 28)	81.48% (N = 22)	83.33% (N = 50)	0.742
Qualified successc	85.29% (N = 29)	100.0% (N = 27)	91.80% (N = 56)	0.060
Qualified successd	100.0% (N = 34)	100.0% (N = 27)	100.0% (N = 61)	1

Notes:

a IOP ≤ 21 mmhg and >20% pressure reduction from baseline;

b IOP ≤ 18 mmhg without glaucoma medication at the last follow–up;

c an IOP ≤ 21 mmhg and >20% pressure reduction from baseline; and

d IOP ≤ 18 mmhg with and without glaucoma medication at the last follow-up. “Postoperative” indicates the time point at last follow-up. The comparison here is between preoperative and last follow up (postoperative time point: last follow up).

Abbreviations: 5-FU, 5-fluororacil; BCVA, best corrected visual acuity; IOP, intraocular pressure; MD, mean deviance; SD, standard deviation.

Figure 2 Mean score of filtering bleb morphology over time.

Abbreviation: IOP, intraocular pressure.

Table 3 Postoperative complications and interventions

	5-FU group	5-FU and bevacizumab group	Total	P-value between the groups
Bleb failure
Bleb needling	14	4	20	0.046
Re-TET	3	0	3	0.248
YAG-goniopuncture	0	2	2	0.192
Cyclophotocoagulation	1	0	1	1
Hypotony
Resutures of the scleral flap	7	1	8	0.066
Injection of healon-GV® (Abbott Laboratories Inc, Abbot Park, IL, USA)	1	0	1	1
Others
Irrigation of the AC	1	0	1	1
Iris repositioning	2	2	4	1

Abbreviations: AC, anterior chamber; Re-TET, re-trabeculectomy; YAG, yttrium aluminum garnet; 5-FU, 5-fluororacil.