Long-term results of preconditioning treatment with bevacizumab in high-risk patients

Session Details

Session Title: Cornea Surgical: Keratoplasties

Session Date/Time: Monday 16/09/2019 | 16:30-18:00

Paper Time: 17:18

Venue: Free Paper Forum: Podium 1

First Author: : R.Fasciani ITALY

Co Author(s): :    A. Caristia   L. Mosca   A. Caporossi                       

Abstract Details

Purpose:

The aim of this study is to evaluate the effect of subconjunctival and/or intrastromal Bevacizumab injections on corneal graft survival rate in high-risk patients. Main outcomes were the number of immune rejection and the graft survival at the end of follow up.

Setting:

Ophthalmology Institute Agostino Gemelli University Policlinic Fondation - IRCCS.

Methods:

In this prospective interventional case-control series were included thirty seven eyes of 37 high-risk patients (case group: 24 patients / control group: 13 eyes). Case group eyes received a cycle of three subconjunctival and/or intrastromal injection of 5 mg/0.2 ml Bevacizumab. Control group did not receive any Bevacizumab injection and directly underwent keratoplasty. All patients were sistematically evaluated by slit-lamp examination and corneal digital photography. Mean follow-up was 61.2 months ± 24 DS for case group and 26.1 months ±5.7 DS (range 16-36 months) for control group.

Results:

In the case group 33.3% haven’t had keratoplasy because regression of vessels guaranteed good visual acuity. Patients who received Bevacizumab injections showed less ocular inflammation and activity of vessels. One corneal graft rejection (4%) was seen during the follow-up after 24 months. At the end of follow-up 20.8% had graft failure. Graft survival occurred in 79.1% of patients. No side effects were detected after the injection procedure. In the control group we observed 46.1%graft rejection 3.8 months ± 1.4 SD after keratoplasty. Graft survival occurred in 53.8% of patients.

Conclusions:

The inflammation reduction and the immunomodulation obtained with the administration of Bevacizumab seems to be a safe and valid possibility to reduce the incidence of graft rejection and to improve the corneal graft survival rate in high risk patients.

Financial Disclosure:

None