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This abstract is assigned to session FRO: Fund for Research in Ophthalmology

Title	FRO: Subconjunctival bevacizumab enhances the antifibrotic effect of MMC and allows to reduce its exposure time to improve safety
Abstract Nr.	1030

Purpose	To determine the most optimal administration route of bevacizumab after GFS and to investigate whether reducing the exposure time and/or dose of MMC in combination with bevacizumab could improve surgical outcome with a lower incidence of side effects.
Methods	In the first experiment, mice were operated and received a subconjunctival (SC), intracameral (IC) or intravitreal (IV) injection of bevacizumab (25µg). Bevacizumab plasma levels were measured using ELISA. In the second experiment, the combination of MMC and bevacizumab was compared to MMC in operated mice. Surgical sponges soaked in MMC 0.02% and 0.01% were investigated and exposed to the sclera for 1 or 2 min. Treatment outcome was studied by clinical investigation of the bleb.
Results	Treatment using a SC, IC or IV bevacizumab equally improved surgical outcome. Importantly, bevacizumab was detected at relatively high levels in plasma shortly after IV injection, whereas minimal bevacizumab absorption was detected only from day 4 after SC or IC administration. Administration of SC bevacizumab combined with 1 or 2 min of MMC 0.02% equally improved bleb area, as compared to MMC 0.02% alone. The combination of bevacizumab and 1 min exposure of MMC 0.01% also significantly improved surgical outcome (versus 1 min MMC 0.01%), although to a lesser extent than the combination with MMC 0.02% for 1 min. Importantly, 25% of the eyes treated for 2 min with MMC showed corneal toxicity, whereas this was not the case after 1 min of administration.
Conclusion	Adjunctive subconjunctival bevacizumab allows to reduce the administration time of MMC 0.02%, thereby eliminating its toxic effects on the cornea while maintaining the beneficial effects on surgical outcome.

Authors 1

Last name	VAN BERGEN
Initials	T
Department	KUL
City	Leuven

Authors 2

Last name	VANDEWALLE
Initials	E
Department	KUL
City	Leuven

Authors 3

Last name	MOONS
Initials	L
Department	KUL
City	Leuven

Authors 4

Last name	STALMANS
Initials	I
Department	KUL
City	Leuven