Department of Ophthalmology, Medical University, Lublin, Poland.
Clin Exp Ophthalmol. 2012 May-Jun;40(4):e135-42. doi: 10.1111/j.1442-9071.2011.02608.x.
The present study compared the effects of adjuvant bevacizumab and 5-fluorouracil on the efficacy and safety of trabeculectomy.
A nonrandomized, prospective, interventional case study.
A total of 62 patients in two groups undergoing primary trabeculectomy.
In Group 1 (21 primary open-angle glaucoma, nine pseudoexfoliative glaucoma), trabeculectomy was performed with an adjuvant 5% solution of 5-fluorouracil administered for 4 min, intraoperatively. In Group 2 (21 primary open-angle glaucoma, 11 pseudoexfoliative glaucoma), trabeculectomy was enhanced with 1.25 mg of bevacizumab applied subconjunctivally immediately before and after surgery and again 1 and 7 days after surgery.
Intraocular pressure, best corrected visual acuity, visual field index, bleb morphology, cornel endothelial cell count.
Mean intraocular pressure was 28.0 ± 8.0 mmHg before 5-fluorouracil-augmented trabeculectomy and 27.8 ± 9.5 mmHg before bevacizumab-augmented trabeculectomy. After 12 months, mean intraocular pressure was 13.6 ± 4.4 mmHg in the 5-fluorouracil group and 14.7 ± 4.7 mmHg in the bevacizumab group. A 30% reduction of initial intraocular pressure was attained in 86.7% of patients in the 5-fluorouracil group and 78.1% of patients in the bevacizumab group at the end of follow up. No significant differences were noted between the two studied groups with respect to corneal endothelial density, visual field indices and postoperative complications.
The 12-month intraocular pressure results showed no significant differences between the two groups of patients after bevacizumab or 5-fluorouracil to augment trabeculectomy. However, to obtain successful intraocular pressure control more patients in bevacizumab group needed medical therapy.
本研究比较了辅助贝伐单抗和 5-氟尿嘧啶对小梁切除术疗效和安全性的影响。
非随机、前瞻性、干预性病例研究。
两组共 62 例原发性小梁切除术患者。
在第 1 组（21 例原发性开角型青光眼，9 例假性剥脱性青光眼）中，术中给予 5% 5-氟尿嘧啶溶液辅助治疗 4 分钟进行小梁切除术。在第 2 组（21 例原发性开角型青光眼，11 例假性剥脱性青光眼）中，在手术前后及术后 1 天和 7 天，经结膜下给予 1.25mg 贝伐单抗增强小梁切除术。
眼压、最佳矫正视力、视野指数、滤过泡形态、角膜内皮细胞计数。
5-氟尿嘧啶增强小梁切除术前平均眼压为 28.0±8.0mmHg，贝伐单抗增强小梁切除术前平均眼压为 27.8±9.5mmHg。12 个月后，5-氟尿嘧啶组平均眼压为 13.6±4.4mmHg，贝伐单抗组为 14.7±4.7mmHg。在随访结束时，5-氟尿嘧啶组 86.7%的患者和贝伐单抗组 78.1%的患者眼压下降 30%。两组患者角膜内皮密度、视野指数和术后并发症比较差异无统计学意义。
贝伐单抗或 5-氟尿嘧啶增强小梁切除术后 12 个月眼压结果无显著差异。然而，为了获得成功的眼压控制，贝伐单抗组需要更多的药物治疗。
