Intraoperative Mitomycin-C versus Bevacizumab on Success Rate of Phacotrabeculectomy

To compare the success rate of mitomycin-C Versus bevacizumab for prevention of bleb failure following phacotrabeculectomy. In this study 74 eyes of 69 patients with uncontrolled IOP, progressive visual field loss and cataract were randomized in two groups. In the first group, after conjunctival peritomy at the sclera flap site, sponge pats soaked in mitomycin C with concentration of 0.25mg/ml were applied for 3 minutes.In the second group, bevacizumab with concentration of 1.25mg/0.5ml was injected adjacent to the bleb at the end of surgery. Seventy four eyes of 69 patients including 41 men and 28 women with mean age of 66.92±9.8 years and 64.57±8.8 years in either study group respectively were included. Data collected from 6 to 12 months after surgery were analyzed. Mean intraocular pressure in the bevacizumab group was significantly higher than the MMC group (15.91±4.9 mmHg vs 12.76±3.1 mmHg, P= 0.001) at 6 months and (15.763.26 mmHg vs 13±2.4 mmHg, P= 0.003) at the end of 12 months. Bleb characteristics including extension, elevation and vascularity showed no significant difference between two groups. (P values 0.94, 0.93, 0.41 after 6 months, and 0.56, 0.58, 0.89 after 1 year of follow up respectively).One eye in the second group underwent trabeculectomy because of uncontrolled IOP despite using 3 antiglaucoma medication. One eye in each group underwent bleb revision due to failing bleb. No sides effects related to the medications were noted in any of the two groups. Mitomycin C is more effective than bevacizumab for IOP control after phacotrabeculectomy; however, there is no difference between the two agents in terms of bleb characteristics and side effects.