Evaluation of Adjunctive Subconjunctival Injection of Bevacizumab before Pterygium Surgery

Abstract

Background: Pterygium is a common ocular surface lesion involves the bulbar conjunctiva's fibrovascular expansion onto the cornea.  The exact cause of pterygium remains unclear, however exposure to ultraviolet radiation is recognized as a significant contributing  element. The development of pterygium is believed to involve vascular endothelial growth factor (VEGF). Bevacizumab, a monoclonal  antibody, functions by attaching to and blocking VEGF.

Aim of study: This study aimed to assess the effectiveness and safety of  preoperative subconjunctival bevacizumab for primary pterygium excision.

Patients and methods: This prospective study included 30  patients with primary pterygium attending the Ophthalmology Outpatient Clinic, Al-Azhar University Hospital, Assiut, Egypt. Patients were  divided into two groups: Group “A” (15 patients) received subconjunctival injection of 2.5 mg bevacizumab 1 week before surgical  excision of the pterygium with conjunctival autograft transplantation. Group “B” (15 patients) underwent pterygium excision with conjunctival autograft transplantation without injection of bevacizumab. Patients were followed up for 6 months.

Results: In group “A”,  14 out of 15 patients (93.3%) showed no recurrence after bevacizumab injection and pterygium surgery. One patient (6.7%) had  recurrence. In group “B”, 6 out of 15 patients (40%) had recurrence after pterygium surgery without bevacizumab injection. The  recurrence rate was significantly lower in the bevacizumab injection group compared to control group (p=0.031). No complications were  observed with subconjunctival bevacizumab injection.

Conclusion: Subconjunctival injection of bevacizumab before surgical excision of  primary pterygium is safe and effective in reducing the recurrence rate.