Abstract

AbstractPurpose Glaucoma filtration surgery (GFS) frequently leads to surgical failure due to excessive postoperative wound healing. The current study was designed to investigate the effect on postoperative scarring of a single subconjunctival (SC), intracameral (IC) or intravitreal (IV) injection of bevacizumab.Methods The effect of bevacizumab (AvastinTM, Genentech) was investigated in a model of GFS in C75Bl/6 mice. Immediately after surgery, mice were divided in 3 groups (n=10 per group) and received a SC, IC or IV injection. In all groups, one eye was injected with bevacizumab (1 µl; 25 µg) and the other eye was used as a control and received an injection of NaCl (1 µl; 0.9%). Treatment outcome was studied by clinical investigation of bleb area and bleb survival every other day. Mice were killed on postoperative day 14 and immunohistological analysis of angiogenesis and collagen deposition were performed.Results In the mouse model of GFS, treatment using a SC, IC, IV injection of bevacizumab significantly improved surgical outcome by increasing bleb area with 53%; with 45% and with 49%, respectively, compared to negative control. Bleb survival significantly improved only after SC injection with 37,5%. In all groups, blood vessel density was significantly reduced after bevacizumab treatment with 36%; with 31% and with 34%, respectively. All administration routes of bevacizumab significantly diminished collagen deposition with 27%, compared to negative control.Conclusion This study shows that a subconjunctival injection of bevacizumab had the largest effect on surgical outcome compared to intracameral and intravitreal injection.

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