Effect of subconjunctival bevacizumab injection before primary pterygium excision: a clinical and immunohistochemical study

Abstract

Purpose The aim of this study was to evaluate the effect of preoperative subconjunctival bevacizumab injection on the clinical and immunohistochemical analysis of primary pterygium. Patients and methods A total of 10 eyes of 10 patients with primary pterygium received a subconjunctival injection of bevacizumab (2.5 mg/0.1 ml) 1 week before simple pterygium excision with bare sclera technique. The control group (10 eyes of 10 patients with primary pterygium) had simple excision of primary pterygium with bare sclera without prior injection. Follow-up was performed on the first week, 2 weeks, 1 month, and 3 months postoperatively to evaluate the surgical site vascularization and occurrence of any complications and to record the rate of recurrence. Immunohistochemical analysis was performed on the excised tissue to detect vascular endothelial growth factor (VEGF) in both groups. Results There was a marked decrease in pterygium vascularity after intralesional injection of bevacizumab. The injection group showed no recurrence after excision of pterygium during the scheduled follow-up period without any recorded complications regarding the use of bevacizumab, whereas the control group showed recurrence of pterygium in three eyes. The immunohistochemical analysis showed lower VEGF in the injected group than in the control group. Conclusion Preoperative injection of bevacizumab effectively reduced vascularity and VEGF concentration of pterygium tissue. A subconjunctival preoperative single dose of bevacizumab was not associated with any adverse effects and was well tolerated. It had a minimizing effect on the extent of vascularization of the pterygium. No recurrence of pterygium was noted in any of the injected patients.

Keywords

• bare sclera
• bevacizumab
• immunohistochemical analysis
• pterygium
• vascular endothelial growth factor