Topical Application of Bevacizumab as an Adjunct to Recurrent Pterygium Surgery

Purpose: To evaluate the clinical outcomes of topical bevacizumab as adjunctive to the surgical excision for treatment of recurrent pterygium. Methods: The 44 patients who underwent recurrent pterygium excision with conjunctival autograft transplantation were enrolled in this prospective and interventional study. The patients were randomized in 2 groups: study group, 1 month after surgery, 22 patients received only topical bevacizumab (5 mg/mL) 4 times daily for 2 months; control group, 1 month after surgery, 22 patients were administered only an artificial tear 4 times daily for 2 months. Patients were prospectively followed for 6 months after pterygium surgery. The main outcome measures were pterygium recurrence, corneal neovascularization, and other postoperative complications. Results: No statistically significant differences were observed between the 2 groups in terms of age, gender distributions, laterality, length of pterygium, and number of recurrence. A pterygium recurrence was not noted in any patients in the study group but was noted in 2 of 22 eyes (9%) in the control group during the follow-up after surgery (P = 0.244). Although none of the patients developed corneal neovascularization in the study group, 5 of 22 eyes (22.7%) developed this condition in the control group during the follow-up after surgery (P = 0.024). No serious complications were observed during the follow-up period in both the groups. Conclusions: Topical bevacizumab therapy 1 month after surgical excision of recurrent pterygium is well tolerated and effective to prevent neovascularization. Although the recurrence rate is lower in the study group without significant difference, further studies are required to support this result.

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