Short-term Results of Trabeculectomy Using Adjunctive Intracameral Bevacizumab: A Randomized Controlled Trial

Purpose: To investigate the outcome of trabeculectomy with or without adjunctive intracameral bevacizumab. Materials and Methods: In this prospective, double-blind, randomized clinical trial, 71 patients with primary open-angle or pseudoexfoliation glaucoma were randomly assigned to receive either 1.25 mg intracameral bevacizumab (n=36) or balanced salt solution as placebo (n=35) at the end of trabeculectomy. Success was defined as at least a 30% drop in intraocular pressure (IOP) compared with baseline values and an IOP between 6 and 21 mm Hg at the last postoperative visit with (qualified) or without (complete) glaucoma medications. Results: Thirty-two patients in bevacizumab group and 33 in placebo group completed a mean follow-up of 10.7 +/- 2.1 and 10.5 +/- 2.5 months, respectively (P=0.731). The mean preoperative IOP was 28.25 +/- 5.64 and 29.11 +/- 4.65mm Hg in the bevacizumab and placebo groups, respectively (P=0.485). Last visit IOP was 14.5 +/- 3.7mm Hg in the bevacizumab group and 18.55 +/- 3.64 mm Hg in the placebo group (P<0.001). At last visit, complete success was achieved in 26 cases (81.3%) of bevacizumab group and 16 cases (48.5%) of placebo group (P<0.006). Filtering bleb leak during the first postoperative month was seen in 11 (34%) and in 3 (9%) cases of bevacizumab and placebo groups, respectively (P=0.013). Conclusions: A single 1.25 mg dose of intracameral bevacizumab significantly improves the success of trabeculectomy; however, it increases the risk of early filtering bleb leakage.