Effect of Pre- and Postoperative Subconjunctival Bevacizumab on Recurrence After Primary Pterygium Excision: A Randomized Placebo-Controlled Trial
Sara Riaz
DOI: http://doi.org/10.63139/aqamc.v2i1.0017
Keywords: Pterygium, Bevacizumab, Anti-VEGF, Recurrence, Subconjunctival Injection
ABSTRACT
Introduction: Pterygium is a common degenerative disorder of the conjunctiva characterized by fibrovascular tissue growth extending onto the cornea. Chronic exposure to ultraviolet radiation, environmental irritants, and occupational hazards contributes to persistent inflammation and angiogenesis. Vascular endothelial growth factor (VEGF) plays a key role in the pathogenesis and recurrence of pterygium following surgical excision.
Objective: To evaluate the effectiveness of pre- and postoperative subconjunctival bevacizumab injections in reducing recurrence after primary pterygium excision.
Methods: This randomized, placebo-controlled study was conducted in the Department of Ophthalmology, King Edward Medical University, Lahore, from January 2024 to January 2025. Forty-four patients with primary Grade II or III pterygium were randomized into two groups. Group A (n=22) received subconjunctival bevacizumab injections (5 mg/0.2 ml) one week preoperatively and (2.5 mg/0.1 ml) on the seventh postoperative day. Group B (n=22) received placebo (normal saline) following the same schedule. All patients underwent bare sclera pterygium excision by a single surgeon. Follow-up examinations were performed at 4, 12, and 24 weeks by a masked observer. Recurrence was defined as fibrovascular tissue extending beyond the limbus onto the cornea.
Results: The study included 25 males and 19 females aged 25–55 years, with no significant demographic differences between groups. At six months, recurrence was observed in 4.5% of patients in Group A compared to 27.3% in Group B, demonstrating a statistically significant reduction in recurrence with bevacizumab (p < 0.05).
Conclusion: Pre- and postoperative subconjunctival bevacizumab significantly reduces the recurrence of primary pterygium after surgical excision and represents an effective adjunctive therapy.
Keywords: Pterygium, Bevacizumab, Anti-VEGF, Recurrence, Subconjunctival Injection