Combined sutureless gluefree conjunctival autograft with subconjunctival bevacizumab for treatment of primary pterygium

Abstract

Purpose The aim of this study was to assess the efficacy of subconjunctival bevacizumab injection as adjuvant therapy in the prevention of recurrence following excision of pterygium and application of sutureless gluefree conjunctival autograft (SL/GF CAG). Patients and methods A prospective randomized comparative study was performed on 20 eyes of 20 patients with primary pterygium. They were divided into two groups: group A (10 eyes) had pterygium excision with SL/GF CAG and received subconjunctival 2.5 mg/0.1 ml of bevacizumab at the end of the surgery and group B (10 eyes) had pterygium excision with SL/GF CAG only followed by eye pressure patching for 24 h in both groups. Results SL/GF CAG was successful in all cases except in one (10%) eye in group B that developed conjunctival graft retraction on the first postoperative day necessitating resurgery. Adjuvant subconjunctival bevacizumab injection used in group A was well tolerated with no systemic or local side effects but in the term of recurrence, no statistically significant difference was reported between the two groups in the postoperative 6 months follow-up period. Conclusion SL/GF CAG is a novel technique for the treatment of primary pterygium. Augmentation of this technique with a single injection of bevacizumab by the end of surgery aiming at reducing the recurrence rate did not seem to provide any statistically significant difference than SL/GF CAG alone, although bevacizumab injection was well tolerated as an adjuvant therapy.

Keywords

• bevacizumab
• pterygium
• sutureless gluefree conjunctival autograft