Randomized, controlled trial of conjunctival autografting combined with subconjunctival bevacizumab for primary pterygium treatment: 1-year follow-up
Por:
Nava-Castañeda A., Olvera-Morales O., Ramos-Castellon C., Garnica-Hayashi L., Garfias Y.
Publicada:
1 abr 2014
Resumen:
Background: To investigate the efficacy and safety of subconjunctival bevacizumab application as an adjuvant therapy for primary pterygium. Design: This study was a clinical randomized trial performed at the Institute of Ophthalmology 'Conde de Valenciana'. Participants: Forty-nine patients with primary pterygium were enrolled in the study. Methods: Each primary pterygium patient was randomized after pterygium excision and a conjunctival autograft to receive either a single 2.5mg/0.1mL dose of subconjunctival bevacizumab immediately after surgery (group 1); a double 2.5mg/0.1mL injection of subconjunctival bevacizumab, one immediately after surgery and the second 15 days after surgery (group 2); or no injection (group 3). Main Outcome Measures: Autoconjunctival graft presence or absence of ischaemia, necrosis, infection or detachment; surgical bed appearance; and pterygium recurrence at 1-year follow-up period were determined. Results: Forty-nine eyes of 49 patients were included. Sixteen patients were assigned to group 1, 17 to group 2 and 16 to group 3. Patients from groups 1 and 2 showed conjunctival autograft ischaemia at 24h postoperative (37.5% and 58.8%, respectively, P>0.05), which disappeared by the first postoperative month. No significant difference in the main outcome measures was found among single versus double-dose of subconjunctival bevacizumab injection patients. At the end of the study, pterygium recurrences were observed only in group 3 (P<0.04). Conclusions: A single 2.5mg/mL subconjunctival bevacizumab injection in conjunction with primary pterygium surgery accomplishing a conjunctival autograft procedure is safe and well tolerated, and is capable of preventing pterygium recurrences when compared with a control group. © 2014 Royal Australian and New Zealand College of Ophthalmologists.
Filiaciones:
Nava-Castañeda A.:
Research Unit, Institute of Ophthalmology Conde de Valenciana, Universidad Nacional Autónoma de México, Mexico City, Mexico
Oculoplastics Department, Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico
Olvera-Morales O.:
Oculoplastics Department, Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico
Ramos-Castellon C.:
Oculoplastics Department, Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico
Garnica-Hayashi L.:
Oculoplastics Department, Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico
Garfias Y.:
Univ Nacl Autonoma Mexico, Fac Med, Biochem Dept, Mexico City 04510, DF, Mexico
Research Unit, Institute of Ophthalmology Conde de Valenciana, Universidad Nacional Autónoma de México, Mexico City, Mexico
Biochemistry Department, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
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