The Effect of Avastin on Posterior Capsular Opacification after Phacoemulsification: A Randomized Controlled Trial Mitsugu

Background: Cataracts are a leading cause of visual impairment in people. Phacoemulsification with intraocular lens (IOL) implantation is the predominant procedure performed for restoration of vision. Highly effective immediate restoration of vision gradually declines due to the development of posterior capsule opacification (PCO). The aim of this study is to compare the success rate of bevacizumab vs. placebo for prevention of PCO following phacoemulsification Materials and Methods: In this double blind randomized clinical trial, thirty patients (60 eyes) underwent cataract extraction by phacoemulsification. 30 eye’s received Avastin in the form of injection between the IOL and posterior capsule (Study group) while 30 eyes were injected BSS (Control group) in the same manner after phacoemulsification. Complete ophthalmic examination including tonometry (IOP, intraocular pressure), visual acuity (VA) and posterior capsule evaluation was done in follow up periodic and PCO densitometry with Pentacam was done in the last follow up (1year). The comparisons were done with Wilcoxon matched pairs test, chi square test and independent samples t-test. Statistical significance was considered at P<0.05. Results: We identified 113 trials, consisting of 39 positive and 74 negative trials (overall success rate: 35%). Most of the primary endpoints (77%) were progression-related or recurrence-related. The success rates of trials assessing progression-related and recurrence-related endpoints were 39% and 17%, respectively. Progression-related and recurrence-related endpoints in the control arm showed significant improvement, compared with pre-trial estimates, which were associated with negative results. Conclusions: Bevacizumab (Avastin) is not more effective than placebo for prevention of PCO following phacoemulsification. However, more studies with greater patient number are suggested.