Antiangiogenic therapy in the surgical treatment of pterygium

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PURPOSE

To evaluate the effectiveness and safety of adjuvant anti-VEGF therapy in the surgical treatment of pterygium, and to determine the indications for its use.

MATERIAL AND METHODS

The study included 67 patients (69 eyes) with grade II—IV pterygium. Patients age was 58.8±12.6 years on average. Best corrected visual acuity (BCVA) varied between 0.01 and 1.0 (0.77±0.24). The patients were divided into 3 groups. The first group included 19 patients (19 eyes) with grade II—III pterygium who underwent «bare sclera» surgery and used aflibercept as adjuvant therapy. The second group included 21 patients (21 eyes) with grade II—IV pterygium who underwent auto conjunctival grafting surgery with no adjuvant therapy. The third group included 27 patients (29 eyes) with grade II—IV pterygium who had it removed in combination with single-time peripheral lamellar keratoplasty (PLK) and underwent adjuvant aflibercept therapy.

RESULTS

Among patients who underwent pterygium excision with adjuvant antiangiogenic therapy there were 5 cases (26%) of relapse during the observation period (23.38±8.96 months), among patients after pterygium excision with auto conjunctival plastic surgery — also 5 cases (24%) of relapse, and among patients who underwent LKP combined with anti-VEGF therapy there was only 1 case (3%) of relapse. Astigmatism has decreased by 0.24±0.5 (p=0.052) in the first group, by 1.21±1.0 (p<0.05) in the second group, and by 1.64±1.54 (p<0.05) in the third group compared with pre-surgical values, thus increasing average BCVA in all 3 patient groups by 0.1±0.13, 0.07±0.11 and 0.15±0.15, respectively.

CONCLUSION

The use of anti-VEGF agents as adjuvant therapy in the surgical treatment of pterygium is a safe method of reducing postoperative inflammation, fibrovascular proliferation and, subsequently, the amount of relapses.

Keywords:

pterygium

aflibercept

anti-VEGF

auto conjunctival plastic surgery

peripheral lamellar keratoplasty

Authors:

Malozhen S.A.

Krasnov Research Institute of Eye Diseases

ORCID: 0000-0003-0534-1536

Trufanov S.V.

Research Institute of Eye Diseases

SPIN RSCI: 1603-8931
Scopus AuthorID: 6508163770
ORCID: 0000-0003-4360-793X

Krakhmaleva D.A.

Research Institute of Eye Diseases

Received:

25.04.2020

Accepted:

13.06.2020

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