1. EVALUATION OF OCULAR SURFACE DISEASE IN PATIENTS AFTER TRABECULECTOMY: COMPARATIVE STUDY WITH AND WITHOUT INTRACAMERAL BEVACIZUMAB
Sónia Parreira; Sandra Barros; Diogo Lopes; Nadine Marques;
Filipe Freitas; Paula Telles; Nuno Campos
Hospital Garcia de Orta, Portugal
INTRODUCTION
FIGURE 1. Ocular Surface Disease Index questionnaire
OCULAR SURFACE DISEASE (OSD)
Multifactorial disease of the tears and ocular surface;
Symptoms of discomfort, visual disturbance and tear film instability.
TRABECULECTOMY
First-line surgical treatment for glaucoma;
Success rate has significantly improved with the ADJUNCTIVE ANTIMETABOLITES treatment, but some complications may compromise visual function postoperatively.
PURPOSE
The aim of this study was to compare clinical signs of OSD in patients who had undergone trabeculectomy with and without BEVACIZUMAB.
FIGURE 2. Slitlamp micrograph of grading scale for corneal fluorescein staining. Grading scale of corneal fluorescein staining score ranged from 0 to 3 points
Grade 0 – no staining
Grade 1 – minimal staining
Grade 2 – mild/moderate staining
Grade 3 – severe staining
MATERIALS AND METHODS
Cross sectional, case comparison study: 21 patients (41 eyes);
GROUP 1: 21 eyes underwent SIMPLE trabeculectomy;
GROUP 2: 9 eyes underwent trabeculectomy with INTRACAMERAL BEVACIZUMAB;
FELLOW EYES: 11 eyes that did not undergo surgery
Patients completed the OCULAR SURFACE DISEASE INDEX (OSDI) questionnaire and total OSDI scores (0-100) were calculated;
Evaluation of FLUORESCEIN corneal staining (score between 0-3) and a SCHIRMER tear test were executed for every patient.
DISCUSSION AND CONCLUSIONS
OSD is a clinical problem often overlooked in patients who undergo filtration surgery;
The use of intracameral bevacizumab could be a SAFE and a possible adjunctive treatment without increasing complications when compared with simple trabeculectomy.
Due to our small sample size, which limits the statistical comparison between the groups, further larger randomized trials are required to investigate the long term results.
RESULTS
Parameters of Group 1 and 2 were compared using the MANN- WHITNEY U test.
Fellow eyes were compared with operated eyes using the WILCOXON test.
There were NO SIGNIFICANT DIFFERENCES in the corneal staining score (P=0.422), Schirmer’s test results (P=0.326) and OSDI scores (P=0.053) between GROUPS 1 and 2.
Corneal staining score was GREATER in OPERATED EYES than in non-operated eyes (1.27 vs 0.64; P=0.02).
FELLOW EYES had SIGNIFICANTLY higher Schirmer’s results than eyes with trabeculectomy (22.00 vs 15.27; P=0.005).
References
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