Blockade of vascular endothelial growth factor (VEGF) with bevacizumab has been used to treat
abnormal vascular conditions of the anterior segment of the eye. In pterygium, anti-VEGF
agents have been recently proposed as primary treatments, such as perioperative adjuvants, as
well as treatments for pterygia recurrences after surgery. The aim of the present study was
to prospectively evaluate the effect of three subconjunctival bevacizumab injections in
patients with an early pterygium recurrence. Materials and Methods: The current study was a
non-randomized single central trial. The method of ensuring allocation concealment was
sequentially numbered. Patients with an early pterygium recurrence were selected and invited
to participate in the study. Recurrence was defined as the presence of corneal vessels with
concomitant conjunctival hyperemia within the first trimester after primary pterygium
removal, and only patients with primary pterygium recurrence were included. Patient related
factors such as pregnancy, women seeking to become pregnant, and lactating women were
excluded from the study. All patients received three subconjunctival bevacizumab (2.5 mg/0.05
ml) injections (basal, 2 and 4 weeks) in the recurrence area of the pterygium, and were
photographed at the third, sixth and twelfth months after the last bevacizumab injection.
Photographic analyses were performed taking into account two pterygium areas: the first
measure included only the vessel area in the corneal surface, while the second measure
included, both, conjunctival and corneal vessel area (corneal-conjunctival area of
hyperemia). Neovascularization area of each pterygium was determined using digital slit lam
pictures, which were analyzed using Photoshop CS4, in order to get pixels measurements of the
lesion.
Details
Lead Sponsor:
Instituto de Oftalmología Fundación Conde de Valenciana
Collaborator:
National Council of Science and Technology, Mexico