THE EFFECT OF BEVACIZUMAB ON ALPHA SMOOTH MUSCLE ACTINEXPRESSION AND FIBROBLAST COUNT TO PREVENT POSTTRABECULECTOMY FIBROSIS IN NEW ZEALAND WHITE RABBIT

Background, the wound healing process is the most common cause of glaucoma surgery failure that causes the incapability of controlling the intraocular pressure (IOP) and progressive optic nerve damage. Objective: This study aimed to analyze the effect of Bevacizumab on myofibroblast and fibroblast in trabeculectomy area of rabbit models in order to find a safer wound healing modulator to improve surgical outcomes. Method: Sixteen New Zealand white rabbits aged 4-6 months and weight between2,5-3,5 kg was performed trabeculectomy on the right eye with postoperative subconjunctival injection of BSS and Bevacizumab. Subjects were put into control and bevacizumab group. Examination were done and subjects were terminated and performed enucleation on postoperative day 14. Samples were histologically stained with Haematoxyline-Eosin to count the fibroblast. Result: Mann Whitney u test and independent t-test were used to analyse the data. We found both less expression of alpha smooth muscle act in and fibroblast count on bevacizumab group compared to control group which indicates less myofibroblast, fibroblast, and less scarring potential in trabeculectomy area. There is significant decrease in expression of α-SMA in bevacizumab group compared to control group (p= 0,0195), and with independent t-test we found less fibroblast in bevacizumab group significantly (p= 0,0005). Conclusion: Bevacizumab inhibits fibroblast proliferation and its differentiation to myofibroblast that lead to less collagen production and fibrosis.