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ORIGINAL ARTICLE
Year : 2014  |  Volume : 107  |  Issue : 2  |  Page : 113-116

The outcome of preoperative subconjunctival bevacizumab injection in pterygium surgery


Department of Ophthalmology, El Minia Faculty of Medicine, El Minia University, El Minia, Egypt

Correspondence Address:
Ahmed S Mohamed
MD, El minia Samalot Elbiha Nasser Ebada Street, El Minia 23244
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2090-0686.140643

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Objective The aim of this study was to evaluate the safety and the efficacy of subconjunctival injection of bevacizumab (Avastin) for the management of primary and recurrent pterygia and to estimate the recurrent rate of pterygia after surgery. Patients and methods The study included 60 eyes of 60 patients (45 male and 15 female), with a mean age of 41 ± 4.8 years. Forty patients (66.6%) had primary pterygia and the remaining 20 patients had recurrent pterygia after a previous surgery. A preoperative injection of bevacizumab was given at a dose of 1.25 mg (0.05 ml) 1 week before pterygium surgery was performed using the conjunctival flap technique. Twenty patients were enrolled as a control group and they were operated upon without preoperative bevacizumab injection. Mitomycin C (0.1 mg/ml) was used intraoperatively in recurrent cases. All patients were followed up for 3-6 months. Results Most of the patients (48.3%) had grade 2 pterygium. The average time for each procedure was 30 ± 15 min. No patient lost vision after the procedure. Recurrence was noted in five patients (8.3%), and all of them had primary pterygia. Conjunctival graft rejection occurred in three patients (5%); this graft rejection occurred in recurrent pterygia. Postoperative conjunctival vascularization occurred in four patients (6.7%), and this vascularization occurred in the recurrent cases. A significant improvement of visual acuity and corneal clearance was noticed in all patients. Conclusion Preoperative subconjunctival injection of bevacizumab reduces the recurrence rate of pterygium surgery as it reduces the vascular element of the pterygium. Intraoperative application of mitomycin C in addition to preoperative subconjunctival injection of bevacizumab reduces recurrence in recurrent pterygium cases. Further long-term, large-scale studies are recommended.


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