Evaluation of topical bevacizumab as an adjunct to mitomycin C augmented trabeculectomy

Purpose to investigate the safety and synergistic effect of topical bevacizumab after trabeculectomy surgery with mitomycin c (mmc). methods in this prospective,non-randomized,comparative interventional study,40 eyes from 40 patients with uncontrolled open-angle glaucoma were studied after they underwent primary trabeculectomy with mitomycin c (0.02% for 2 min). following the procedure topical bevacizumab (4 mg/ml) was used for 2 weeks 4 times daily in group a. patients in group b received routine postoperative care. the outcome measures were the intraocular pressure (iop),number of anti-glaucoma medications,complications,and bleb evaluation. results of the 32 eyes that had at least 6 months follow-up,16 were treated with adjuvant topical bevacizumab. the mean preoperative iop in group a improved from 26.7 ± 9.3 mmhg with 2.8 ± 1.3 anti-glaucoma medications to 10.5 ± 2.8 mmhg with 0.7 ± 1 anti-glaucoma medications at last follow-up (p < 0.001). the mean preoperative iop in group b improved from 21.8 ± 6.6 mmhg with 3 ± 0.8 anti-glaucoma medications to 11.4 ± 3.6 mmhg with 0.8 ± 1.2 anti-glaucoma medications at last follow-up (p < 0.001). there was an overall reduction of 54.4% and 43.7% in the iop in groups a and b,respectively (p = 0.18). the cystic type of bleb was less common in group a (p = 0.043). one patient in group a developed a streptococcal corneal ulcer 1.5 months after surgery. conclusion administration of topical bevacizumab 4 mg/ml for two weeks following trabeculectomy with mitomycin-c did not significantly affect the iop trend,but significantly decreased the cystic bleb formation in short-term follow-up. © 2017 iranian society of ophthalmology