Subconjunctival Bevacizumab for Primary Pterygium Excision; a Randomized Clinical Trial

To evaluate the local safety of bevacizumab and its effect on recurrence of primary pterygium excision. This randomized, placebo-controlled clinical trial was conducted on 44 eyes of 44 patients randomized to Group 1 (bevacizumab) and Group 2 (balanced salt solution). Group 1 underwent pterygium excision with a rotational conjunctival flap and received a total of 7.5 mg subconjunctival bevacizumab (5 mg / 0.2 mL on the day of surgery and 2.5 mg / 0.1 mL on the fourth day after surgery). Group 2 received balanced salt solution in the same manner. Recurrence, defined as any fibrovascular tissue crossing the limbus, and the number of patients with > 1.5 mm fibrovascular overgrowth on the cornea were compared between the study groups. There was no statistically significant difference between the study groups in terms of demographics, pterygium size, daily sun exposure, preoperative visual acuity, keratomeric readings, corneal astigmatism, or IOP (P > 0.05). Three and four patients in each group at the three- and six-month visits, respectively, had more than 1.5 mm fibrovascular tissue overgrowth on the cornea (P = 1 and 0.62, respectively). At the three-month visit, 3 patients in Group 1 versus 7 patients in Group 2 (P = 0.13), and at the six-month visit 4 patients in Group 1 versus 8 patients in Group 2 (P = 0.17) had fibrovascular tissue crossing the limbus. Patients in Group 1 experienced a statistically significant rise in IOP at the one-week visit (P = 0.007). Bevacizumab had no significant effect on the recurrence rate of pterygium. Although the frequency of fibrovascular tissue crossing the limbus in the bevacizumab group was half that of the BSS group, the difference failed to reach a statistically significant level.