Purpose: To evaluate the effects of
bevacizumab in 3 different application methods, subconjunctival injection (SCI),
hyaluronic acid retardant (HAR), and
eye drop (ED), on attenuating
scar formation in the filtering
bleb. Methods:
Trabeculectomy (TRAB) was performed on New Zealand rabbits. TRAB rabbits were intervened with
bevacizumab SCI, HAR, ED, or
mitomycin C, respectively. Intraocular pressure (IOP) of 1, 7, 14, and 28 days after TRAB was recorded, and the
bleb survival rate was analyzed.
Bleb height, area, and vascularization were evaluated using anterior segment optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) at 7, 14 and 28 days after surgery. A histopathology examination of the
bleb tissue was performed. The expression levels of
vascular endothelial growth factor (
VEGF)-A,
interleukin (IL)-1α,
tumor necrosis factor-alpha (TNF-α), transforming growth factor-β1 (TGF-β1), and α-smooth muscle actin (α-SMA) were measured by Western blot. Results:
Bevacizumab significantly reduced postoperative IOP and increased the survival of the filtering
bleb, especially in the ED group. Less vascularization was shown in the SCI, HAR, and ED groups. Histopathological results showed the fewest levels of
scarring and
fibrosis in the ED group. The local
VEGF-A, IL-1α, and TNF-α expression levels after
bevacizumab ED were decreased, combined with suppression of TGF-β1 and α-SMA. Conclusions: Postoperative use of
bevacizumab EDs was an effective application method for improving surgical outcomes after TRAB in rabbits. It might be effective in preventing
scarring of the filtering
bleb by antivascularization and anti-
inflammation.