The role of vascular endothelial growth factor and bevacizumab on the wound healing in trabeculectomy patients

Proper wound healing and scaring are the key factor to the success of trabeculectomy in glaucoma patients.The inadequate wound healing will lead to bleb leakage and ocular hypotension after surgery; however, excessive wound healing and scaring will cause the failure of the surgery and eventually increase the intraocular pressure.The applying of antimetabolic drugs such as mitomycin C (MMC) and 5-fluorouracil (5-FU) are able to relieve the excessive wound healing in some degree; however, the side effects like ocular hypotension, dysesthesia endophthalmitis can never be ignored.What is worse, some patients are not sensitive to such drugs.Subconjunctival injection of CAT-152 (monoclonal antibody against transforming growth factor-β) was able to control wound healing in animal trabeculectomy model, while failed in multi-center clinical trial.Recent studies have focused on the role of vascular endothelial growth factor (VEGF) and VEGF inhibitors on the wound healing after trabeculectomy.This paper aims to review the mechanism of wound healing after trabeculectomy, as well as the role of anti-VEGF on this kind of wound healing and scaring.