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Comparison of the use of 5‐fluorouracil and bevacizumab in primary trabeculectomy: results at 1 year
Author(s) -
JurkowskaDudzińska Justyna,
KosiorJarecka Ewa,
Żarnowski Tomasz
Publication year - 2012
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/j.1442-9071.2011.02608.x
Subject(s) - medicine , bevacizumab , trabeculectomy , fluorouracil , ophthalmology , primary (astronomy) , optometry , surgery , glaucoma , chemotherapy , physics , astronomy
A bstract Background: The present study compared the effects of adjuvant bevacizumab and 5‐fluorouracil on the efficacy and safety of trabeculectomy. Design: A nonrandomized, prospective, interventional case study. Participants: A total of 62 patients in two groups undergoing primary trabeculectomy. Methods: In Group 1 (21 primary open‐angle glaucoma, nine pseudoexfoliative glaucoma), trabeculectomy was performed with an adjuvant 5% solution of 5‐fluorouracil administered for 4 min, intraoperatively. In Group 2 (21 primary open‐angle glaucoma, 11 pseudoexfoliative glaucoma), trabeculectomy was enhanced with 1.25 mg of bevacizumab applied subconjunctivally immediately before and after surgery and again 1 and 7 days after surgery. Main Outcome Measures: Intraocular pressure, best corrected visual acuity, visual field index, bleb morphology, cornel endothelial cell count. Results: Mean intraocular pressure was 28.0 ± 8.0 mmHg before 5‐fluorouracil‐augmented trabeculectomy and 27.8 ± 9.5 mmHg before bevacizumab‐augmented trabeculectomy. After 12 months, mean intraocular pressure was 13.6 ± 4.4 mmHg in the 5‐fluorouracil group and 14.7 ± 4.7 mmHg in the bevacizumab group. A 30% reduction of initial intraocular pressure was attained in 86.7% of patients in the 5‐fluorouracil group and 78.1% of patients in the bevacizumab group at the end of follow up. No significant differences were noted between the two studied groups with respect to corneal endothelial density, visual field indices and postoperative complications. Conclusions: The 12‐month intraocular pressure results showed no significant differences between the two groups of patients after bevacizumab or 5‐fluorouracil to augment trabeculectomy. However, to obtain successful intraocular pressure control more patients in bevacizumab group needed medical therapy.