Bevacizumab Eye Drops Versus Intra-Meibomian Gland Injection Of Bevacizumab For Meibomian Gland Dysfunction

This study aimed to evaluate the efficacy and safety of bevacizumab eye drops compared with those of an intra-meibomian gland injection of bevacizumab when performed in conjunction with standard lid hygiene in patients with meibomian gland dysfunction (MGD).

This prospective, open-label, observer-blinded randomized controlled trial included 60 eyes of 30 patients with MGD who exhibited lid margin telangiectasia, treated at the Chula Refractive Surgery Center of King Chulalongkorn Memorial Hospital (Bangkok, Thailand) from September 2020 to May 2021.

Patients were randomized to receive lid hygiene plus 0.05% bevacizumab eye drops or a single intra-meibomian gland injection of 2.5% bevacizumab. All patients were instructed to perform routine lid hygiene care as demonstrated in an instructional video. Primary outcomes included telangiectasia grading and the lid margin neovascularized area (LMNA). Secondary outcomes included the Ocular Surface Disease Index (OSDI) value, corneal staining, meibomian gland quality, meiboscore, conjunctival redness, fluorescein break-up time (FBUT), lipid layer thickness, treatment compliance, and adverse events. All parameters were evaluated before and 3 months after treatment.

After treatment, there were no significant differences in telangiectasia grade and LMNA between groups: however, the injection group exhibited significant improvements relative to baseline in telangiectasia grade and LMNA, but not in the eye drop group. The injection group also exhibited significant improvements in corneal staining, meiboscores, and FBUT. OSDI scores, corneal staining, meibomian gland quality, meiboscores, and conjunctival redness significantly improved relative to baseline in both groups. No local and systemic AE was observed at month 3 in both groups.

When performed with regular lid hygiene, intra-meibomian gland injection and conjunctival application of bevacizumab are safe and effective for improving lid margin telangiectasia and the signs and symptoms of MGD. This therapy may represent an alternative or adjunctive treatment for patients with MGD.