Efficacy of Bevacizumab Compared to Mitomycin C Modulated Trabeculectomy in Primary Open Angle Glaucoma: A One-Year Prospective Randomized Controlled Study

Kaushik, Jaya; Parihar, Jitendra Kumar Singh; Jain, Vaibhav; Gupta, Sandeep; Nath, Pramod; Durgapal, Prashant; Ram, Jagat

doi:10.3109/02713683.2016.1164188

Cited by 16 publications

(12 citation statements)

References 22 publications

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“…12 Studies comprising small numbers of patients who underwent GFS with bevacizumab treatment as an adjuvant antifibrotic therapy produced mixed results in relation to surgical outcome. [13][14][15][16][17][18][19][20] The human data contrasted with the more promising observations obtained in in vitro studies on conjunctival fibroblasts, the main effector cells implicated in fibrosis of the conjunctiva, and in in vivo studies in rabbit models of GFS. [21][22][23][24] The in vivo mechanism(s) for the observed antifibrotic property of bevacizumab is unclear, although these laboratory studies implicated the capacity of bevacizumab to inhibit fibroblast proliferation as well as reduce expression of profibrotic TGF-b and collagen deposition as reasons behind the improved experimental surgical outcomes.…”

mentioning

confidence: 73%

Bevacizumab Promotes T-Cell–Mediated Collagen Deposition in the Mouse Model of Conjunctival Scarring

Seet

Toh

Chu

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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confidence: 73%

Bevacizumab Promotes T-Cell–Mediated Collagen Deposition in the Mouse Model of Conjunctival Scarring

Seet

Toh

Chu

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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“…Vandewalle et al [16] reported a lower risk of postoperative needling in the bevacizumab + MMC group compared with the MMC alone group. Combining MMC with an anti-VEGF agent showed lower vascularity around the bleb and nonbleb areas of conjunctiva compared with antimetabolite alone [10,25]. VEGFs and their receptors play an important role in angiogenesis during wound healing [26].…”

Section: Discussionmentioning

confidence: 99%

“…Fakhraie et al [9] reported that intracameral bevacizumab significantly increased the complete success rate of trabeculectomy compared with placebo. Kaushik et al [10] reported that control of IOP was similar in the subconjunctival bevacizumab group and the MMC group. A lower degree of peripheral bleb and nonbleb vascularity was found in the bevacizumab treatment group [10].…”

Section: Introductionmentioning

confidence: 99%

“…Kaushik et al [10] reported that control of IOP was similar in the subconjunctival bevacizumab group and the MMC group. A lower degree of peripheral bleb and nonbleb vascularity was found in the bevacizumab treatment group [10]. However, a recently published Cochrane systematic review reported that anti-VEGF alone may not be as effective as MMC in controlling IOP over 12 months [11].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and Safety of Bevacizumab Combined with Mitomycin C or 5-Fluorouracil in Primary Trabeculectomy: A Meta-Analysis of Randomized Clinical Trials

et al. 2018

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Aim: The objective of this study was to evaluate the efficacy and safety of bevacizumab combined with antimetabolite as an adjunctive therapy in primary trabeculectomy for glaucoma. Materials and Methods: PubMed, Cochrane Library, and EMBASE were searched for relevant randomized controlled trials. Efficacy was evaluated by the postoperative mean intraocular pressure (IOP), complete success, and qualified success rates. Safety was evaluated by postoperative complications and surgical interventions. Results: A total of 3 randomized controlled trials were included in the meta-analysis. The primary outcome was postoperative mean IOP at the 12-month follow-up. No significant difference in IOP was found between the bevacizumab + antimetabolite (mitomycin c or 5-fluorouracil) group and the antimetabolite alone group (weighted mean difference –0.27; 95% CI –1.38 to 0.83). There were no significant differences in complete success rates, qualified success rates, postoperative complications, and surgical interventions between the experimental treatment group and the conventional treatment group. Conclusions: Results of the meta-analysis demonstrated that the combination of bevacizumab (1.25 mg/mL) with a regular concentration of antimetabolite did not show more benefit or harm compared with using antimetabolite alone. Further randomized controlled trials are needed to evaluate the efficacy and safety of bevacizumab combined with lower concentrations and a shorter application time of antimetabolite.

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“…Vahedian Z and Kaushik J reported that adjunctive bevacizumab in trabeculectomy is effective and comparable to MMC [16,17] . In addition, results of a meta-analysis showed that the combination of bevacizumab with antimetabolites did not show any benefit or harm compared with antimetabolites alone [18] .…”

Section: Introductionmentioning

confidence: 99%

Comparison between Ologen implant and Mitomycin C in trabeculectomy: A Systematic Review and Meta-Analysis

Liu¹,

Du²,

Mei³

et al. 2019

Preprint

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Objective To evaluate the effectiveness and safety of the biodegradable collagen matrix (Ologen) implant in trabeculectomy. Research design and methods We searched Pubmed, Cochrane library, Embase and Web of Science databases to find studies that met our pre-stated inclusion criteria. Reference lists of retrieved articles were also reviewed. The search was finished by February 2019. Study selection, data extraction, quality assessment, and data analyses were performed according to the Cochrane standards. Either a fixed or a random-effects model was used to calculate the overall combined risk estimates. The efficacy measures were the weighted mean differences (WMDs) for the intraocular pressure reduction (IOPR) and the glaucoma medications reduction, the odds ratio (OR) for the success rate and adverse events. Results Fifteen randomized controlled trials involved 682 eyes were included in the meta-analysis. There were no statistically differences between two groups in the IOPR at any time postoperatively. The MD of the IOPR was [MD= -0.45,95% Confidence Interval (CI), (-2.36,1.46), P=0.65] at one day, [MD= -0.82,95% CI, (-1.97, 0.33), P=0.16] at one week, [MD= -1.33, 95% CI,(-3.12, 0.47), P=0.15] at one month, [MD= 0.11,95% CI, (-1.87, 2.08), P=0.92] at three months, [MD= -0.60,95% CI, (-2.27, 1.06), P=0.48] at six months, [MD= -0.33,95% CI, (-1.99, 1.32), P=0.69] at one year, [MD= -0.13,95% CI, (-1.90, 1.65), P=0.89] at two years, [MD= 2.54,95% CI, (-2.83, 7.90), P=0.35] at three years, [MD= 3.04,95% CI, (-3.95, 10.03), P=0.39] at five years. There was no statistically significant difference between the Ologen groups and MMC groups concerned the complete success rate [OR=1.19, 95%CI, (0.83, 1.71), P=0.35]. With regard to the adverse events, no obvirously significance was observed. Seven studies reported the change of antiglaucoma medications. We found that the change of antiglaucoma medications is higher in MMC groups than that in Ologen groups [MD=-0.18, 95%CI, (-0.33, -0.03), P=0.02]. There is no significant difference in complications between the two groups. Conclusions From the current evidence, Ologen may be an alternative choice for trabeculectomy when considering the efficacy and safety. However, MMC might be the preferred choice concerned cost-effectiveness.

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Efficacy of Bevacizumab Compared to Mitomycin C Modulated Trabeculectomy in Primary Open Angle Glaucoma: A One-Year Prospective Randomized Controlled Study

Abstract: Adjunctive bevacizumab in trabeculectomy is effective and comparable to MMC for controlling IOP in POAG patients for the first year.

Cited by 16 publications

References 22 publications

Bevacizumab Promotes T-Cell–Mediated Collagen Deposition in the Mouse Model of Conjunctival Scarring

Bevacizumab Promotes T-Cell–Mediated Collagen Deposition in the Mouse Model of Conjunctival Scarring

Efficacy and Safety of Bevacizumab Combined with Mitomycin C or 5-Fluorouracil in Primary Trabeculectomy: A Meta-Analysis of Randomized Clinical Trials

Comparison between Ologen implant and Mitomycin C in trabeculectomy: A Systematic Review and Meta-Analysis

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