Efficacy and safety of Bevacizumab versus MMC in augmenting trabeculectomy：a Meta-analysis / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

AIM: To compare the efficacy and safety of bevacizumab with mitomycin ( MMC ) in augmenting trabeculectomy for glaucoma. METHODS: Databases including PubMed, CBM, CNKI, VIP and WanFang Data were electronically searched for all randomized controlled trials ( RCTs) about comparing the efficacy and safety between bevacizumab and MMC in augmenting trabeculectomy for glaucoma before the date of Jun. 2016. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, and evaluated the included studies. Then, Meta-analysis was performed. RESULTS: A total 4 RCT involving 286 eyes ( 143 for bevacizumab group, 143 for MMC group) were included. The results of Meta-analysis showed that there was no significant difference between bevacizumab and MMC in the last follow-up after surgery in IOP (WMD=2. 21, 95%CI: -0.17 to 4.58, P=0.07), complete success rate (OR=0. 69, 95%CI:0. 26 to 1. 81, P=0. 45) and the numbers of anti-glaucoma medicine ( OR= 0. 12, 95%CI: -0. 15 to 0.39,P=0. 39). And there was no significant difference between bevacizumab and MMC in postoperative complications:hypotony (OR=0.7, 95%CI:0.12 to 4.05, P=0.69), bleb leak (OR=1, 95%CI: 0. 21 to 4. 74,P=1), encapsulated bleb (OR=1. 15, 95%CI: 0. 38 to 3. 44, P=0.81), choroidal detachment (OR=1. 22, 95%CI: 0. 29 to 5.22, P=0. 78) and cataract (OR=1. 15, 95%CI: 0. 38 to 3.44, P=0. 81). CONCLUSION: Bevacizumab and MMC in augmenting trabeculectomy for glaucoma have similar efficacy and safety. Bevacizumab can't result in better outcome in term of IOP reduction. Clinicians should choose suitable solution according to disease characteristics.