Efficacy of sub-conjunctival and topical bevacizumab in high-risk corneal transplant survival

Objective: to evaluate the effectiveness of subconjunctival bevacizumab and topical bevacizumab in preventing neovascularisation on high-risk corneal grafts. methods: the randomised, controlled, parallel group study was carried out from february 2008 to april 2012 at isra postgraduate institute of ophthalmology and yasin eye hospital, karachi. eyes with high-risk corneal transplantation with corneal neovascularisation were included in the trial. patients were randomly allocated to 3 groups: a, b and c. after penetrating keratoplasty, group a patients received subconjunctival bevacizumab (2.5 mg/ 0.1 ml), group b, patients received sham injection, while group c patients received topical bevacizumab (2.5%, 25 mg/ml). it was self-administered 4 times a day for 24 weeks. group b was the control group. corneal neovascular invasion area was measured using mathematical software programme mat lab. data analyses were done using spss version 19. results: of the total 122 patients, there were 41 (33.88%) each in group a and b, while group c had 40 (32.78%) patients. among the 3 groups, mean corneal neovascular invasion area was minimum in group a (n=3; 6.23%), while in group b it was 12.3% (n=5). group c had the maximum corneal neovascular invasion area after 24 weks (n=11; 26.7%). maximum number of patients (n=36; 87.80%) attained visual acuity of 6/36 or better in group a followed by group c (n=26; 65%) and group b (n=17; 41.46%). conclusion: subconjunctival bevacizumab reduces the recurrence of neovascularisation and, thus, helps increasing the frequency of graft survival in cases of high-risk corneal transplants. when used topically, it is less effective.