The effect of different doses of subconjunctival bevacizumab on the recurrence rate of excised primary pterygium.

Purpose: To evaluate the safety of different doses of subconjunctival bevacizumab and their effects on the recurrence rate after primary pterygium excision.

Methods: This prospective randomized placebo-controlled clinical study was conducted on 59 eyes (59 patients). The visual acuity, refractive astigmatism, horizontal length of the pterygium, and recurrence risk factors were recorded. There were no statistically significant differences between the groups for age, sex, horizontal length of pterygium, preoperative visual acuity, astigmatism, and recurrence risk factors. The pterygium was excised from the conjunctival side and then peeled off the cornea. The bare sclera was covered with a rotational conjunctival flap from the superonasal area. After surgery, Group 1 (22 patients), Group 2 (17 patients) and Group 3 (20 patients) received 7.5 mg bevacizumab, 2.5 mg bevacizumab, and Balanced Salt Solution (BSS) subconjunctivally, respectively. Postoperatively, horizontal length of corneal epithelial defect, conjunctival congestion, and lacrimation were checked on the first and seventh day. The rate of recurrence (>1.5 mm fibrovascular overgrowth on the cornea) at month 6 was compared between the groups.

Results: There were no statistically significant differences between the groups for all measured variables except for moderate conjunctival congestion on the first postoperative day which was more common in the bevacizumab groups (P=0.002). Four eyes in Groups 1 (20%) and 2 (26.7%) and 3 in Group 3 (15.8%) experienced recurrence (p=0.73). All recurrences occurred at month 3 and subsequently thereafter.

Conclusions: In our study, perioperative injections of subconjunctival bevacizumab had no effect on primary pterygium recurrence and were not associated with any specific local complications.