The following is a summary of “Intravitreal bevacizumab improves trabeculectomy survival at 12 months: the bevacizumab in trabeculectomy study—a randomized clinical trial,” published in the August 2023 issue of Opthalmology by Landers et al.
Researchers performed a retrospective study to assess the efficacy of intravitreal bevacizumab (Avastin) during trabeculectomy with mitomycin-C (MMC) in improving surgical success over 12 months.
The study recruited glaucoma patients needing trabeculectomy. Patients were randomly assigned to receive either intravitreal bevacizumab or a placebo. The primary outcome was to determine treatment success, categorized as ‘complete success’ if intraocular pressure remained below a set target without eye drops or ‘qualified success’ if eye drops were needed to reach the target. Other factors included were the necessity for additional pressure-lowering interventions and structural indicators linked to the effectiveness of bleb function.
Out of the 131 patients initially randomized, 128 (98%) completed the 12-month follow-up, with 65 receiving bevacizumab and 66 receiving placebo. After 12 months, the bevacizumab group showed higher success rates (complete success: 94% vs. 83%, p=0.015; qualified success: 98% vs. 90%, p=0.033). In the placebo group, there was a greater need for topical therapy at 6 and 12 months (p=0.045) and a higher requirement for bleb needling at one month (P=0.035). Blebs in the bevacizumab group were larger at one month (P<0.001) and exhibited less vessel inflammation (P<0.0001).
The study found intravitreal bevacizumab during trabeculectomy with MMC improved surgical success at 12 months and reduced the need for additional medication or surgery. This approach also led to larger, less inflamed blebs that required fewer subsequent interventions.
Source: bjo.bmj.com/content/early/2023/08/04/bjo-2023-323526?rss=1
