Subconjuntival injection of bevacizumab in side of filtering bleb in the end of trabeculectomy : first experience

Purpose To evaluate safety and local effects of ‐in the end of trabeculectomy Avastin injection on filtering bleb vascularisation and bleb failing trend. Methods 1 male patients 65yo with a clinical history of pharmacologically uncontrolled primary open angle glaucoma in right eye (IOP 36 mmHg,CCT=525 µ)underwent to trabeculectomy without use of antiproliferative agents. A traditional surgical approach with a 12 o’clock scleral wedge(4 x 4 mm) and a double Nylon 10/0 made sclerocorneal suture using modified Meduri’s technique was performed.At the end of the surgery ,0.05 ml of bevacizumab ( Avastin 25 mg/ml , Roche) were injected in the subconjutival space above the sclera wedge.The IOP and bleb vascularisation have been recordered in the post op each day during the first week and one time a week in the following three months.A digital camera mounted on slit lamp was used for images acquisition. Results IOP was stable on 9 mmHg during the first three weeks , increasing to 16 mmHg during the follow up and stable until the end of the study despite removing Meduri’ sclerocorneal sutures . No complications were seen in the anterior chamber . Filtering bleb did not show any sign of inflammation or swelling with a “ quite “ vascularisation as clinical marker during the follow up . Conclusion Our short experience demonstrates the safety of subconjuntival injection of Avastin and effects on bleb’s vascularisation regardless of incidence of bleb failure.Further investigations in multicentric randomized studies on larger sample size are necessary to confirm current results .