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Bevacizumab in the Treatment of Pterygium: A Meta-Analysis

Hu, Qiongwen MD; Qiao, Yanbing PhD; Nie, Xin MD; Cheng, Xiaocheng MD; Ma, Yongping PhD

doi: 10.1097/ICO.0000000000000037
Clinical Science

Purpose: The aim of this study was to assess the efficacy and safety of bevacizumab in the treatment of pterygium and to mainly explore its effects on recurrence rate and complications.

Methods: We searched MEDLINE, EMBASE, Web of Science, and Cochrane Central Register from the inception to July 2013 for relevant randomized controlled trials that examined bevacizumab therapy for pterygium. Data concerning study design, patient characteristics, treatment, and outcomes were extracted. The methodological quality of the studies included was assessed using the Jadad score. Relative risk (RR) was calculated for recurrence rate and complications.

Results: A total of 474 patients with 482 eyes in 9 randomized controlled trials were analyzed. The pooled estimate showed that bevacizumab had no statistically significant effect on preventing pterygium recurrence [RR 0.90, 95% confidence interval (CI) 0.77–1.07, P = 0.23]. None of the subgroup analyses yielded significant results in favor of bevacizumab (surgery group: RR 0.77, 95% CI 0.50–1.18, P = 0.23; nonsurgery group: RR 0.98, 95% CI 0.86–1.11, P = 0.76; primary pterygium group: RR 0.82, 95% CI 0.53–1.26, P = 0.36; recurrent pterygium group: RR 0.95, 95% CI 0.82–1.09, P = 0.44). There were no statistically significant differences in the complications between the 2 groups (RR 1.00, 95% CI 0.73–1.37, P = 1.00). However, the bevacizumab group was associated with a higher risk of developing subconjunctival hemorrhage (RR 3.34, 95% CI 1.07–10.43, P = 0.04).

Conclusions: Topical or subconjunctival bevacizumab was relatively safe and well tolerated, but it had no statistically significant effect on preventing pterygium recurrence. A large-scale trial with a suitable dosage and a longer follow-up would be required to rule out the possibility of any treatment benefit.

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*Key Laboratory of Biochemistry and Molecular Biology, Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing, China;

Department of Ophthalmology, The Third People's Hospital of Chongqing, Chongqing, China; and

Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, The Chongqing Cardiac Arrhythmias Service Center, Chongqing, China.

Reprints: Yongping Ma, Key Laboratory of Biochemistry and Molecular Biology, Molecular Medicine and Cancer Research Center, Chongqing Medical University, Chongqing 400016, China (e-mail: yongpingm@yahoo.com).

The authors have no funding or conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.corneajrnl.com).

Received August 11, 2013

Accepted October 21, 2013

Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.