The Effect of Subconjunctival Bevacizumab Injection before Conjunctival Autograft for Pterygium.

Kim, Yong Il; Lee, Geun Young; Kim, Eun Joo; Kim, Yeoun Hee; Lee, Kyoo Won; Park, Young Jeung

doi:2015.56.6.847

J Korean Ophthalmol Soc > Volume 56(6); 2015 > Article

Original Article

Journal of the Korean Ophthalmological Society 2015;56(6):847-855.
DOI: https://doi.org/10.3341/jkos.2015.56.6.847 Published online June 15, 2015.

The Effect of Subconjunctival Bevacizumab Injection before Conjunctival Autograft for Pterygium.

Yong Il Kim, Geun Young Lee, Eun Joo Kim, Yeoun Hee Kim, Kyoo Won Lee, Young Jeung Park

Cheil Eye Hospital, Daegu, Korea. eyepark9@naver.com

군날개 치료로서 술 전 베바시주맙 주입 후 시행한 자가결막이식술의 효과

김용일⋅이근영⋅김은주⋅김연희⋅이규원⋅박영정

제일안과병원

Received: 14 August 2014 • Revised: 1 December 2014 • Accepted: 23 April 2015

Abstract

PURPOSE
To evaluate the effect of subconjunctival bevacizumab injection before conjunctival autograft for pterygium. METHODS: Twenty-five eyes (25 patients) with pterygium received a subconjunctival injection of 2.5 mg (0.1 mL) bevacizumab 1-2 weeks prior to conjunctival autograft surgery. The control group (25 eyes of 25 patients) received the same operation. Two weeks, 1 month and every month after the surgery, the vascularization of surgical site, the recurrence rate and the effect of wound healing were analyzed. RESULTS: The bevacizumab group showed a decreased conjunctival vascularity grade compared with the control group based on light microscopy. The bevacizumab group also showed lower vascular epithelial growth factor (VEGF) compared with the control group using immunohistochemical analysis and western blot. There was no recurrence in both groups, but, persistent autograft edema was observed at 8 weeks postoperatively in the bevacizumab group. CONCLUSIONS: Although preoperative injection of bevacizumab effectively reduced vascularity and VEGF concentration of pterygium tissue, prolonged autograft edema was observed. Based on these results, bevacizumab inhibits lymphangiogenesis as well as angiogenesis. Therefore, delayed wound healing should be considered when subconjunctival bevacizumab injection is administered before pterygium surgery.

Key Words: Bevacizumab;Conjunctival autograft;Lymphangiogenesis;Pterygium;VEGF