Comparison of Subconjunctival Bevacizumab and Mitomycin C to Prevent Bleb Failure After Glaucoma Filtration Surgery

1. Mitra Zamani
2. Mahmoud Reza Panahibazaz
3. Farideh Sharifipour

Departement of ophthalmology, Ahwaz Jundishapour University of Medical Sciences, Ahwaz, Iran

Purpose: To compare subconjunctival Bevacizumab and Mitomycin-C (MMC) as an adjunct to trabeculectomy in patients undergoing first time trabeculectomy for primary open angle glaucoma or chronic angle closure glaucoma.

Methods: 39eyes underwent trabeculectomy with intraoperative 0.02% MMC and 31 eyes underwent trabeculectomy with 1.25 mg subconjunctival Bevacizumab adjunct to the bleb administered immediately after trabeculectomy. Intaocular pressure (IOP) and bleb characteristics according to the Indiana Appearance Grading Scale were evaluated 1,7,30, 90 and 180 days after surgery. Treatment success was unmedicated IOP of 6 to 18 mmHg at 6 months.

Results:Mean age was 56.6±10 years in MMC and 57.5±10.2 in Bevacizumab group.The mean preoperative IOP was 29.2±12.1 mmHg in MMC and 26.4±8.9 in Bevacizumab which was decreased to 10±4.5 in MMC and 12.1 ±5.1 in Bevacizumab group on day 1 (p=0.97),11.2±4.5 in MMC and 11.5±4.5 in Bevacizumab on day 7 (p=0.748), 13±4.5 in MMC and 11.2±3.4 in Bevacizumab on day 30 (p=0.108),11.5±4.3 in MMC and 11.9±3.7 in bevacizumab on day 90 (p=0.985) and 12±3.4 in MMC and 11.6±3.8 in bevacizumab on day 180 (p=0.799).Bleb failure happened in 7 cases in MMC and 5 cases in Bevacizumab group.(p=1.00)

Conclusion: There were no statistically significant differences between subconjunctival Bevacizumab and intraoperative MMC application as an adjunct to trabeculectomy.