Session Title: Cornea
Session Date/Time: Sunday 05/02/2012 | 08:30-11:00
Paper Time: 10:33
Venue: Hall 1
First Author: : J.Martins PORTUGAL
Co Author(s): : B. Vieira J. Serino P. Barros P. Rodrigues J. Neves Martins
Purpose:
To evaluate the safety and tolerability of ranibizumab given via subconjunctival injection in patients with recurrent pterygium undergoing pterygium surgery with autograft placement. The previously described technique of conjunctival autograft in primary pterygium excision decreases the number of proven recurrence. However, the treatment of recurrent pterygium is a continuing therapeutic challenge. The autograft of limbal cells is essential in the treatment of relapses. Recent studies have shown an increase in growth of endothelial factor (VEGF) in pterygium, so it started using anti-angiogenic therapy in their treatment.
Setting:
Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Porto, Portugal
Methods:
This is a retrospective, comparative and observational study of 12 patients with recurrent pterygium, who underwent surgery at Pedro Hispano Hospital, between 7/2010 and 7/2011. The minimum follow-up was 6 months. The patients were randomly divided in two groups A and B. Patients underwent Subconjunctival ranibizumab (0.5 mg/0.05 mL) injection administered at the limbus, adjacent to pterygium either 8 days prior to surgery (Group A, n = 6) or 3 days prior to surgery (Group B, n = 6). Safety and tolerability of subconjunctival ranibizumab as determined by patient reporting, clinical examination, and masked observer interpretation of slit-lamp photographs. RESULTS The median age at presentation was 62 years; 75% of patients were male. Six patients were randomly assigned to be injected with 0.05 mg ranibizumab via subconjunctival injection 8days prior to surgery; an additional 6 patients were injected with ranibizumab 3 days prior to surgery. All 10 patients tolerated the injection well. The conjunctival autograft remained intact in the all the patients. No other safety concerns arose after 6 months of follow-up. Two pterygium recurrences were noted at 6 months (all patients in Group A). All remaining patients had a normal surgical bed appearance.
Conclusions:
The data from this small pilot study suggest that 1 subconjunctival injection of ranibizumab in conjunction with pterygium surgery is well tolerated. The anti-angiogenic therapy is not effective as a single treatment of relapsed pteryium, by its declining share over time. However it seems to be an important adjunct to excision of recurrent pterygium, because it reduces some of intraoperative complications such as bleeding. However wider series are needed to prove the action of anti-VEGF with the rate of relapse.
Financial Disclosure:
No
