Can preoperative bevacizumab improve trabeculectomy outcome? Avastin‐Trab study

Purpose The aim of this project is to study whether peroperative intracameral bevacizumab (Avastin®) might improve the outcome of filtration surgery. Methods This study will be carried out in a prospective, placebo‐controlled, double‐blinded experimental setup. The effect of peroperative administration of bevacizumab on intraocular pressure, bleb characteristics and post‐operative medication and surgical intervention will be investigated. The risk of systemic side‐effects will minimalized by using local anti‐Vascular Endothelial Growth Factor treatment. The study patients will be divided into two major groups: A) Patients with primary open angele glaucoma and B) Patients with normotensive glaucoma, in which very low IOPs are targeted. Both groups of patients will undergo a trabeculectomy. Patients in group A will not be given the antimetabolite Mitomycin C (MMC), while patients in group B will receive MMC to obtain sufficiently low IOPs. This strategy adheres to standard operating procedures for filtration surgery. Results will follow Conclusion Our study will potentially shed new light on a plausible and simple method to improve the prognosis of glaucoma filtration surgery. Since this study will provide direct data on the effectiveness of a one‐time treatment that might reduce the risk of bleb failure after filtration surgery, avoiding or reducing the need for long‐term medication use or secondary surgical intervention, the potential clinical implications of this study are clear. Thus, our project opens exciting new perspectives for the treatment and prognosis of the blinding condition of glaucoma