Local Injection of Bevacizumab as an Alternative Method for Management of Recurrent Pterygium

Background: Surgery has so far been used for primary treatment of pterygium; however, one of the major limitations is its high recurrence rate. This study was performed to determine the effect of bevacizumab in recurrent pterygium. Methods: Patients with recurrent pterygium were divided into two groups, receiving bevacizumab (Group 1) or normal saline (Group 2). They were evaluated for photophobia and any conjunctival congestion and were scored from 0 to 4 prior to any injection. The size of pterygium was assessed in relation to extension of pterygium on the cornea over the limbus. All patients were followed in regular 48 hour intervals weekly up to one month and then monthly up to 6 months after the injection. Results: There were 50 patients in group 1 and 48 in group 2 and the mean age of the patients was 40.94±13.82 and 47.10±5.9 years, respectively with a male to female ratio of 1 2 . The mean size of ptrygium was 52.84 in group 1 and 46.02 in group 2. In group 1, photophobia and conjunctival congestion were 59.53 and 61.27, respectively while in group 2, they were 39.16, and 37.24, respectively. In the first 48 hours, conjunctival congestion and photophobia were higher in group 1 but there was no significant difference regarding the size of pterygium. After one week, the scores were significantly lower in group 1 while the mean rank for the size of pterygium was 52.84 in group 1, and 46.02 in group 2. After 1 and 6 months, the scores were lower in group 1. Conclusion Subconjunctival injection of bevacizumab can be considered as an effective temporary treatment in the management of recurrent pterygium in those who are not a candidate for secondary operation. It can decrease conjunctival congestion and photophobia and prevent further progression even in the long term.