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ORIGINAL ARTICLE
Year : 2013  |  Volume : 106  |  Issue : 2  |  Page : 137-142

Efficacy of intraoperative topical use of bevacizumab (Avastin) versus mitomycin C in the surgical management of primary pterygia


Department of Ophthalmology, Cairo University, Cairo, Egypt

Correspondence Address:
Safwat K Elkady
MD, Department of Ophthalmology, Cairo University, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.7123/01.JEO.0000431555.89602.3d

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Purpose

This study will evaluate the efficacy of the intraoperative use of bevacizumab (Avastin) as an adjunctive medication during pterygium surgery versus mitomycin C in the surgical management of primary pterygia.

Patients and method

Forty patients with primary pterygia were enrolled in this study. They were divided randomly into two groups. The first group included 20 patients who received 1.25 mg/ml of bevacizumab applied one time intraoperatively using a bevacizumab-soaked filter paper that was manually applied to the bare sclera during pterygium surgery for a duration of 2 min, followed by copious rinsing with a balanced salt solution.

The second group included 20 patients who received mitomycin C 0.02% applied to bare sclera during pterygium surgery using a medication-soaked filter paper for a duration of 2 min. After the administration of medication, the ocular surface was copiously irrigated with a balanced salt solution.

Patients were followed up for 2 years (mean, 15 months).The possible complications and recurrence rates were documented.

Results

Recurrence was more commonly encountered in the Bevacizumab group than in the group treated with mitomycin C (50 vs. 30%), respectively. This difference was statistically significant (P=0.05).

The rate of complications was comparable between the two groups (46.25% in the Avastin group vs. 58.75% in the mitomycin C group) (P=0.61). None of these complications was clinically significant, and they resolved spontaneously or with the use of conservative measures.

Conclusion

Intraoperative use of mitomycin C as adjunctive medication during pterygium surgery was more effective in preventing recurrence of pterygium in comparison with Bevacizumab (Avastin) in the surgical management of primary pterygia. The rate of complications with both techniques was clinically insignificant.



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