Subconjunctival bevacizumab to augment trabeculectomy with mitomycin C in the management of failed glaucoma surgery

Ahmed M Saeed, Tarek Tawfeek AboulNasrOphthalmology Department, Benha University, Egypt Purpose: To provide a feasible solution to the problem of failed glaucoma surgery. The aim was to evaluate the efficacy and safety of the additional effects of a combined surgical approach. This approach augment...

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Autores principales:	Saeed AM, AboulNasr TT
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/4136707ea7e1490782c0a3724a820463
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spelling	oai:doaj.org-article:4136707ea7e1490782c0a3724a8204632021-12-02T00:57:51ZSubconjunctival bevacizumab to augment trabeculectomy with mitomycin C in the management of failed glaucoma surgery1177-5483https://doaj.org/article/4136707ea7e1490782c0a3724a8204632014-09-01T00:00:00Zhttp://www.dovepress.com/subconjunctival-bevacizumab-to-augment-trabeculectomy-with-mitomycin-c-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483 Ahmed M Saeed, Tarek Tawfeek AboulNasrOphthalmology Department, Benha University, Egypt Purpose: To provide a feasible solution to the problem of failed glaucoma surgery. The aim was to evaluate the efficacy and safety of the additional effects of a combined surgical approach. This approach augments the application of trabeculectomy with mitomycin C (MMC) by adding subconjunctival bevacizumab injection. The results were compared with those of trabeculectomy with only adjunctive MMC. Methods: A randomized controlled prospective clinical trial included 28 eyes diagnosed with failed scarred bleb of a previous trabeculectomy. The eyes were divided into two equal groups: combined group A, “trabeculectomy with adjunctive MMC and subconjunctival bevacizumab,” and control group B, “trabeculectomy with adjunctive MMC only.” The main outcome results included the cumulative probability of surgical success, intraocular pressure (IOP) values, and number of IOP-lowering medications needed to achieve the target IOP.Results: Group A achieved a cumulative probability of complete success of 0.769 and of qualified success of 0.231 at the end of the 24 month study period; group B achieved cumulative probabilities of 0.538 and 0.308, respectively. Group A achieved a lower mean IOP value than group B, with fewer antiglaucoma drugs at all postoperative visits, but this lower value did not reach a statistically significant level (P>0.05). There was no statistically significant difference between both groups regarding best corrected visual acuity, visual field parameters, operative and/or postoperative complications, and additional interventions. No significant adverse effects were caused by this combined approach.Conclusion: Bevacizumab was not found to add much to the favorable long-term outcome of conventional trabeculectomy with MMC as a solution to the problem of scarred failed bleb. Keywords: glaucoma, bevacizumab, mitomycin C, failed trabeculectomy, bleb failure, scarred blebSaeed AMAboulNasr TTDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2014, Iss default, Pp 1745-1755 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Saeed AM AboulNasr TT Subconjunctival bevacizumab to augment trabeculectomy with mitomycin C in the management of failed glaucoma surgery
description	Ahmed M Saeed, Tarek Tawfeek AboulNasrOphthalmology Department, Benha University, Egypt Purpose: To provide a feasible solution to the problem of failed glaucoma surgery. The aim was to evaluate the efficacy and safety of the additional effects of a combined surgical approach. This approach augments the application of trabeculectomy with mitomycin C (MMC) by adding subconjunctival bevacizumab injection. The results were compared with those of trabeculectomy with only adjunctive MMC. Methods: A randomized controlled prospective clinical trial included 28 eyes diagnosed with failed scarred bleb of a previous trabeculectomy. The eyes were divided into two equal groups: combined group A, “trabeculectomy with adjunctive MMC and subconjunctival bevacizumab,” and control group B, “trabeculectomy with adjunctive MMC only.” The main outcome results included the cumulative probability of surgical success, intraocular pressure (IOP) values, and number of IOP-lowering medications needed to achieve the target IOP.Results: Group A achieved a cumulative probability of complete success of 0.769 and of qualified success of 0.231 at the end of the 24 month study period; group B achieved cumulative probabilities of 0.538 and 0.308, respectively. Group A achieved a lower mean IOP value than group B, with fewer antiglaucoma drugs at all postoperative visits, but this lower value did not reach a statistically significant level (P>0.05). There was no statistically significant difference between both groups regarding best corrected visual acuity, visual field parameters, operative and/or postoperative complications, and additional interventions. No significant adverse effects were caused by this combined approach.Conclusion: Bevacizumab was not found to add much to the favorable long-term outcome of conventional trabeculectomy with MMC as a solution to the problem of scarred failed bleb. Keywords: glaucoma, bevacizumab, mitomycin C, failed trabeculectomy, bleb failure, scarred bleb
format	article
author	Saeed AM AboulNasr TT
author_facet	Saeed AM AboulNasr TT
author_sort	Saeed AM
title	Subconjunctival bevacizumab to augment trabeculectomy with mitomycin C in the management of failed glaucoma surgery
title_short	Subconjunctival bevacizumab to augment trabeculectomy with mitomycin C in the management of failed glaucoma surgery
title_full	Subconjunctival bevacizumab to augment trabeculectomy with mitomycin C in the management of failed glaucoma surgery
title_fullStr	Subconjunctival bevacizumab to augment trabeculectomy with mitomycin C in the management of failed glaucoma surgery
title_full_unstemmed	Subconjunctival bevacizumab to augment trabeculectomy with mitomycin C in the management of failed glaucoma surgery
title_sort	subconjunctival bevacizumab to augment trabeculectomy with mitomycin c in the management of failed glaucoma surgery
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/4136707ea7e1490782c0a3724a820463
work_keys_str_mv	AT saeedam subconjunctivalbevacizumabtoaugmenttrabeculectomywithmitomycincinthemanagementoffailedglaucomasurgery AT aboulnasrtt subconjunctivalbevacizumabtoaugmenttrabeculectomywithmitomycincinthemanagementoffailedglaucomasurgery
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Subconjunctival bevacizumab to augment trabeculectomy with mitomycin C in the management of failed glaucoma surgery

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