Purpose: The aim of this study was to detect the clinical and histological effects of preoperative
subconjunctival injection of both bevacizumab and mitomycin C (MMC) 1 month before the
surgical excision of primary pterygium using a bare sclera technique.
Patients and methods: A total of 20 patients with primary pterygium underwent
subconjunctival combined injection of 0.1 mL of MMC (0.1 mg/mL) and 0.1 mL of bevacizumab
(1.25 mg/0.1 mL) 1 month before bare sclera excision of the pterygium. The excised pterygium
tissues were examined histologically and immunohistologically by CD31 staining, and the
patients were followed up clinically for at least 2 years. The excised pterygia of two patients
without preoperative injection were used for histological comparison.
Results: Clinically, there were no intraoperative or postoperative complications. No recurrence
was noted during the follow-up period. Histologically, the previously injected pterygia showed a
decreased number of epithelial cells and stromal fibroblasts. The latter were rounded or oval and
swollen rather than spindle shaped, and some were degenerating or apoptotic. Collagen and elastic
fibers were degenerated, distorted, and decreased in density, while blood capillaries were obliterated.
There was a significant decrease in CD31-positive cells in previously injected pterygia.
Conclusion: Preoperative subpterygium combined injection of bevacizumab and MMC is safe
and effective in reducing the postoperative recurrence of primary pterygium. Histological and
immunohistological changes in the form of decreased fibrovascular activity and degeneration
of the extracellular matrix and nerve axons were noted