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Randomized, controlled trial of conjunctival autografting combined with subconjunctival bevacizumab for primary pterygium treatment: 1‐year follow‐up
Author(s) -
NavaCastañeda Angel,
OlveraMorales Osiris,
RamosCastellon Cynthia,
GarnicaHayashi Lilia,
Garfias Yonathan
Publication year - 2014
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.12140
Subject(s) - medicine , pterygium , bevacizumab , randomized controlled trial , surgery , ophthalmology , chemotherapy
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 O phthalmology ‘ C onde de V alenciana’. 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 2.5 mg/0.1 m L dose of subconjunctival bevacizumab immediately after surgery (group 1); a double 2.5 mg/0.1 m L 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 24 h 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 2.5 mg/m L 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.