Efficacy of bevacizumab injection after pterygium excision and limbal conjunctival autograft with limbal fixation suture.

Abstract

To determine the efficacy of subconjunctival bevacizumab injection after pterygium excision with limbal conjunctival autograft and limbal fixation suture. This retrospective study included a total of 150 eyes of 150 patients with primary pterygium who received three different procedures after pterygium excision, i.e., 49 eyes with limbal conjunctival graft (group A), 48 eyes with limbal conjunctival autograft with limbal fixation suture (group B), and 53 eyes with limbal conjunctival autograft with limbal fixation suture followed by bevacizumab injection (group C). Image analysis was performed using preoperative anterior segment photographs to measure parameters including relative length, relative width, relative area, and vascularity index of pterygium. Recurrence of pterygium was determined at 1year after surgery, and outcomes were compared between the 3 groups. Risk factors related to recurrence were evaluated using univariate and multivariate analyses. Recurrence rates after 1year were 18.4% (9/49), 8.3% (4/48), and 1.9% (1/53)in groups A, B, and C, respectively (P= 0.004). Multivariate analysis showed that patients in group C had significantly reduced risk of recurrence compared with those in group A (P= 0.009), whereas the risk of recurrence was not significantly different between groups A and B (P= 0.227) and groups B and C (P= 0.068), respectively. Among various parameters, higher vascularity index had significant correlation with increased risk of recurrence (P= 0.008). Bevacizumab injection after limbal conjunctival autograft and limbal fixation suture may effectively reduce recurrence after pterygium excision. The vascularity of pterygium was associated with a higher risk of recurrence.