Rom J Ophthalmol. 2026 Jul-Sep;70(3):393-400. doi: 10.22336/rjo.2026.54.
ABSTRACT
OBJECTIVE: Pterygium is a common ocular condition, and excision with conjunctival autografting is the standard treatment. Recurrence after surgery is a known complication, and various adjunctive modalities are used along with excision to reduce recurrence. The use of vascular endothelial growth factor (VEGF) inhibitors, such as bevacizumab (Avastin), has been shown to reduce recurrence in several studies. This study was conducted to evaluate the efficacy of subconjunctival and topical Bevacizumab (BVZ) in preventing recurrence after pterygium surgery.
METHODS: This was a multi-center randomized controlled trial in which 1,800 patients were recruited and divided into three groups. In Group C, standard treatment of pterygium excision and conjunctival autografting was performed. Additionally, in Group A, subconjunctival BVZ was administered post-operatively and again 1 week after surgery, whereas in Group B, topical BVZ was administered for 4 weeks post-operatively. Recurrence was assessed at six and twelve months, along with visual acuity and complication rates.
RESULTS: Out of 1,800 patients recruited, 332 patients (18.44%) were lost to follow-up. Visual acuity in all three groups showed significant improvement at six and twelve months. The recurrence rate in Groups A and B was significantly lower than in Group C at both the six- and twelve-month follow-ups. The complication rates among the three groups were comparable.
DISCUSSION: The findings demonstrate that both subconjunctival and topical bevacizumab significantly reduce pterygium recurrence when used as adjuncts to conjunctival autografting, without increasing complications. These results support the role of VEGF inhibition in limiting postoperative fibrovascular proliferation and are consistent with previous studies. Although follow-up losses occurred, the large multicenter design strengthens the reliability and clinical applicability of the findings.
CONCLUSIONS: When used as an adjunct, both subconjunctival and topical bevacizumab reduce the recurrence rate following primary pterygium excision with conjunctival autografting.
PMID:43001110 | PMC:PMC13744665 | DOI:10.22336/rjo.2026.54
