Short-term Results of Trabeculectomy Using Adjunctive Intracameral Bevacizumab

Fakhraie, Ghasem; Ghadimi, Hadi; Eslami, Yadollah; Zarei, Reza; Mohammadi, Massood; Vahedian, Zakieh; Mafi, Mostafa; Moghimi, Sasan

doi:10.1097/ijg.0000000000000202

Cited by 17 publications

(17 citation statements)

References 37 publications

(55 reference statements)

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“…folgsrate als in den Placebogruppen. Fakhraie et al bestätigten 2016 signifikante Unterschiede in der Senkung der Anzahl der drucksenkenden Medikamente und des Augeninnendrucks zugunsten der Avastin-Gruppe im Vergleich zur Kontrollgruppe [28].…”

Section: Resultsunclassified

Monozentrische, retrospektive, vergleichende Studie zur Sicherheit und Effektivität der Wundheilungsmodulation mit Bevacizumab nach kombinierter Kataraktoperation mit CyPass-Stent-Implantation

Höh

Holland

Medra

2019

Klin Monbl Augenheilkd

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Zusammenfassung Hintergrund Aufgrund des bekannten positiven Effekts der Wundheilungsmodulation mit Bevacizumab (Avastin®) bei Trabekulektomie wurde in einer retrospektiven Studie die Sicherheit und Wirksamkeit der Wundmodulation mit Avastin nach kombinierter Kataraktoperation mit CyPass-Stent-Implantation untersucht. Methode Retrospektiv wurden die prä-, intra- und postoperativen Daten nach 3 und 6 Monaten bei 484 Augen mit kombinierter Operation erhoben (n = 187 ohne Avastin, n = 297 mit Avastin). Sicherheitskriterien waren intraoperative Komplikationen und postoperative spaltlampenmikroskopische Befunde. Wirksamkeitskriterien waren Augeninnendruck (IOD) und Anzahl drucksenkender Medikamente. Ergebnisse Bezüglich der Alters- und Geschlechtsverteilung, der frühpostoperativen Fibrinreaktion, der Augeninnendruck- und Medikationssenkung unterscheiden sich die beiden Gruppen (mit und ohne Avastin) nicht statistisch signifikant. In der Avastin-Gruppe zeigten sich 3 Monate postoperativ statistisch signifikant weniger Irisgewebsreaktionen als in der Vergleichsgruppe (Chi-Quadrat-Test: p = 0,02, n = 47/128); nach 6 Monaten noch ein leichter Trend (Chi-Quadrat-Test: p = 0,15, n = 45/125). Weitere Trends zugunsten der Avastin-Gruppe wurden für die Versagerquote mit 2 gegenüber 6% nach 3 Monaten (Chi-Quadrat-Test: p = 0,103, n = 50/130) bzw. 4 und 10% nach 6 Monaten (Chi-Quadrat-Test: p = 0,106, n = 50/130) und für den Anteil der Augen ohne ergänzende drucksenkende Medikation mit 86 gegenüber 74% bzw. 68 vs. 56% (Chi-Quadrat-Test: 3 Monate: p = 0,053; 6 Monate: p = 0,12; n = 50/130) ermittelt. Für den Anteil der Augen, der postoperativ ohne ergänzende drucksenkende Medikation die Druckschwelle von ≤ 21 mmHg erreicht, zeigte sich 3 Monate postoperativ mit 85 gegenüber 74% (Chi-Quadrat-Test: p = 0,099, n = 50/130) und nach 6 Monaten mit 65 gegenüber 54% ebenfalls ein starker Trend zugunsten der Avastin-Gruppe (Chi-Quadrat-Test: p = 0,11, n = 50/130). Schlussfolgerung Die Eingabe von Avastin in die Vorderkammer ist sicher, reduziert die Gewebsreaktionen der Iris und verbessert bis zu 6 Monate postoperativ die Effektivität in klinisch begrenztem Umfang.

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Section: Resultsunclassified

Monozentrische, retrospektive, vergleichende Studie zur Sicherheit und Effektivität der Wundheilungsmodulation mit Bevacizumab nach kombinierter Kataraktoperation mit CyPass-Stent-Implantation

Höh

Holland

Medra

2019

Klin Monbl Augenheilkd

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“…Additionally, bevacizumab+ MMC groups might have no advantage in decreasing IOP when compared with MMC groups (MD = −0.08, 95%CI, [−2.14, 1.98] P = 0.94) (Figure 3 B). However, 5 studies 15 , 17 , 18 , 20 , 21 reported IOP at the 6-month. The change of IOP in the bevacizumab groups was significantly higher than the placebo groups (MD = 3.07, 95%CI, [0.87, 5.27], P = 0.006).…”

Section: Resultsmentioning

confidence: 99%

The Effects of Bevacizumab in Augmenting Trabeculectomy for Glaucoma

Liu

2016

Medicine

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The aim of the study was to assess the effects of bevacizumab in augmenting trabeculectomy for glaucoma.We searched the databases of Cochrane Library, PubMed, Embase, CNKI, and VIP. All the databases were retrieved from the time databases established to September, 2015. The keywords we used were as follows: “bevacizumab,” “anti-VEGF,” “avastin,” “trabeculectomy,” “glaucoma,” and so on. We used a method of the freedom word search and the MeSH search combined, which was recommended by Cochrane Systematic Review Manual 5.1.2. Randomized controlled trails (RCTs) of frequently used bevacizumab in trabeculectomy for glaucoma were included. Study selection, data extraction, quality assessment, and data analysis were performed according to the Cochrane standards.Eight randomized controlled trails involving 212 eyes in the experimental (bevacizumab or bevacizumab + mitomycin C) groups and 214 eyes in the control (mitomycin C or placebo) groups were selected. Compared with placebo, bevacizumab significantly increased the complete success rate [OR = 2.79, 95%CI, (1.47, 5.29), P = 0.002], what else, bevacizumab also significantly decreased the intraocular pressure (IOP) [MD = 3.07, 95% CI, (0.87, 5.27), P = 0.006] at the 6-month after trabeculectomy and the number of antiglaucoma medications [MD = 1.23, 95% CI, (0.66, 1.80), P < 0.0001]. Additionally, it also increased the risk of bleb leak [OR = 5.24, 95% CI, (1.30, 21.10), P = 0.02]. When compared with mitomycin C (MMC), bevacizumab significantly increased the rate of encysted blebs [OR = 4.62, 95% CI, (1.02, 20.91), P = 0.05]. However, there was no significantly difference between the bevacizumab + MMC groups and MMC groups whatever the items were.Bevacizumab was an effective way in trabeculectomy concerning the complete success rate, IOP, and anti-glaucoma medications reduction when compared with placebo; however, it increased the risk of bleb leakage. And it significantly increased the rate of encysted blebs compared with MMC.

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“…In a case series of trabeculectomy with adjuvant intracameral bevacizumab, it was reported that despite higher rates of surgical success, bevacizumab was associated with increased conjunctival leakage in the early postoperative period. 22 However, there are no reports of increased early or late postoperative complications of trabeculectomy associated with TA.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Adjuvant Intracameral Triamcinolone Acetonide on the Surgical Results of Trabeculectomy with Mitomycin C

Alagöz¹,

Alagöz²,

Yıldırım³

et al. 2016

tjo

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Objectives:To evaluate the effect of adjuvant intracameral triamcinolone acetonide (TA) on the surgical results of trabeculectomy with mitomycin C.Materials and Methods:All consecutive trabeculectomy cases performed in the glaucoma clinic between July 2012 and December 2013 were retrospectively reviewed from the patient charts. Only those with follow-up of 12 months or longer were included. Patients with intraoperative intracameral TA (study group, n=19) were compared to those without TA (control group, n=21) in terms of surgical success, intraocular pressure (IOP) change, medication use and complications.Results:Forty eyes of 31 patients (21 male/10 female, mean age 64.2±13.8 years) were included in the study. The mean follow-up period was 20.9±5.1 months and 20.7±6.7 months in the study and control groups, respectively (p=0.830). Baseline IOP was 26.4±9.9 and 25.2±7.6 mmHg (p=0.979), and final IOP was 12.7±2.6 and 13.6±3 mmHg in both groups respectively (p=0.226). At the final follow-up, complete success was observed in 68.4% and 52.4% of the study and control groups (p=0.349) and anti-glaucoma medication was used by 31.6% (mean number of medications: 0.79±1.2) and 47.6% (mean number of medications: 1.33±1.7), respectively (p>0.05). Bleb encapsulation, leakage, suture-lysis and hypotony rates were similar in both groups (for all, p>0.05). Cataract progression was noted in six (35.3%) and in five (26.3%) of the phakic eyes in the study and control groups, respectively (p=0.720).Conclusion:When used intracamerally, TA did not increase the complication rate in trabeculectomy surgery. Although the group that received TA showed lower IOP levels, use of fewer medications and fewer eyes requiring medication, the differences did not reach significance.

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Short-term Results of Trabeculectomy Using Adjunctive Intracameral Bevacizumab

Abstract: A single 1.25 mg dose of intracameral bevacizumab significantly improves the success of trabeculectomy; however, it increases the risk of early filtering bleb leakage.

Cited by 17 publications

References 37 publications

Monozentrische, retrospektive, vergleichende Studie zur Sicherheit und Effektivität der Wundheilungsmodulation mit Bevacizumab nach kombinierter Kataraktoperation mit CyPass-Stent-Implantation

Monozentrische, retrospektive, vergleichende Studie zur Sicherheit und Effektivität der Wundheilungsmodulation mit Bevacizumab nach kombinierter Kataraktoperation mit CyPass-Stent-Implantation

The Effects of Bevacizumab in Augmenting Trabeculectomy for Glaucoma

The Effect of Adjuvant Intracameral Triamcinolone Acetonide on the Surgical Results of Trabeculectomy with Mitomycin C

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