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Article Type

Original Study

Abstract

Background Pterygium is a common condition. Many theories have been proposed for its pathogenesis, but excessive sun exposure is the most accepted. Studies show that immunostaining of vascular endothelial growth factor is more intensive in pterygial than in normal conjunctival sections. Objectives The aim of the study was to conduct a trial evaluating the role of antivascular endothelial growth factor in the management of pterygium. Materials and methods Fifty eyes with primary pterygium were included in a nonrandomized trial to evaluate the effect of subconjunctival bevacizumab before excision using the bare sclera technique. None of the eyes had any history of previous ocular disease or surgery. Eyes were examined at presentation, 3 weeks after injection, and 3 and 6 months postoperatively. Examinations included best-corrected visual acuity (BCVA), slit-lamp, and fundus examinations. Pterygium was assessed with regard to site, vascularity, horizontal length, and recurrence after 3 and 6 months. Recurrence was defined as any fibrovascular growth over the cornea 1 mm beyond the limbus. Results There were statistically significant results regarding age, sex, and occupation; 72% were male; the average age was 43.00 ± 13.47 years; 80% worked outdoors. The pterygia resolved with a postoperative recurrence rate of 36% after 6 months. After injection, there was no statistically significant difference regarding improvement in visual acuity. There was significant improvement in ocular irritation, inflammation (82.14%), and horizontal length. Preinjection length average was 2.99 ± 1.08 mm and postinjection length average was 1.78 ± 0.99 mm. Vascularity improved in all cases by one grade after injection. Before injection, 14 cases (28%) were grade I, 22 cases (44%) were grade II, and 14 cases (28%) were grade III. Three weeks after injection, 36 cases (72%) were grade I and 14 cases (28%) were grade II. Conclusion Subconjunctival bevacizumab is well tolerated without local or systemic side effects. The main effect was reduction of inflammation and vascularity of the pterygium with no effect on recurrence.

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