Histological Effects of the Use of Bevacizumab in the Surgical Site After Trabeculectomy
Narrative Responses:
Purpose
The purpose of this study of the trabeculectomy surgery rabbit model is to determine, which treatment modality between subconjunctival bevacizumab, intravitreal bevacizumab and subconjunctival 5-FU treatments is most effective in reducing neovascularisation, inflammation and fibrosis of the surgical site.
Methods
Forty-eight white New Zealand rabbits which were underwent trabeculectomy separated into 4 groups. In the postoperative period, balanced salt solution was injected into the bleb in group 1, bevacizumab was injected into the bleb in group 2 and into the vitreus in group 3, 5-fluorouracil injected into the non-bleb area in group 4. On post-operative days 10, 20 and 30, operated eyes of 2 animals from each group were enucleated. The trabeculectomy site was placed in parafin and 5 μm consecutive sections were made. Hematoxylin-eosin and Masson's trichrome staining was used. Each preparation was assigned a semi-quantitative histological stage.
Results
In all three observations made on days 10, 20, 30, the group treated with subconjunctival bevacizumab had lower levels of inflammation(p=0,030), neovascularization(p=0,004) and fibrosis(p<0,000).
Conclusion
Wound healing is the most important cause of surgical failure after trabeculectomy. This might lead to inability in controlling of IOP postoperatively. We have shown that the subconjunctival bevacizumab injection applied in the post-operative period has significantly lowered level of scarring and fibrosis, therefore, increased the success rate of trabeculectomy.