local injection of bevacizumab for treatment of primary active pterygium

purpose: to report subconjunctival injection of bevacizumab (avastin) for treatment of primary active pterygium. method: patients with primary active pterygia without other ocular disease, pregnancy or diabetes mellitus were enrolled. patients were randomly allocated into two groups to receive injection of avastin or placebo. patients were evaluated for changes in photophobia, conjunctival congestion and size of the pterygium. results: in the first 48 hours, conjunctival congestion was greater in the treatment group as compared to the placebo group (125.76 vs 73.98, p<0.001). the same was observed for photophobia (139.01 vs 69.18, p<0.001), but there was no difference in the size of pterygium between the two groups (105.86 vs 94.08, p= 0.130). after one week, conjunctival congestion (90.98 vs 108.20, p= 0.01) and photophobia (85.08 vs 114.36 p<0.001) were less marked in the treatment group; however, mean pterygium size did not differ between the two groups (105.89 vs 94.06, p= 0.120). this trend continued up to 6 months after the injection, the time at which the results regressed to become similar to those observed 48 hours after injection. conclusion: local injection of bevacizumab may be effective in treatment of pterygium; however, repeat injections should be considered.