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目的:评估术前1wk玻璃体腔内注射贝伐单抗对增生性糖尿病视网膜病变(PDR)玻璃体手术(PPV)的效果。方法:对46例PDR患者进行回顾性研究,46例患者随机分为玻璃体手术(PPV)组(n=28)和IVB组(n=18,PPV术前注射贝伐单抗)。玻璃体术前1wk注射贝伐单抗,比较两组间视力,医源性视网膜裂孔发生率,术中和术后出血情况。结果:术后1mo,PPV组和IVB组视力都明显提高(82.1%对88.9%)(P<0.01),两组间并无明显差异。医源性视网膜裂孔发生率PPV组18例,IVB组4例(64.3%对22.2%)(P<0.05)。术中出血PPV组28例,IVB组7例(100%对39%)(P<0.01),术后出血PPV组9例,IVB组0例(32.1%对0)(P<0.01)。结论:术前注射贝伐单抗可以减少增生性糖尿病视网膜病变玻璃体手术中医源性视网膜裂孔、术中出血和术后出血发生率。
PURPOSE: To evaluate the efficacy of intravitreal bevacizumab 1 vitrectomy for proliferative diabetic retinopathy (PDR) vitreous surgery (PPV) at 1 week before surgery. METHODS: Forty-six patients with PDR were retrospectively studied. Forty-six patients were randomly divided into two groups: vitreous operation (n = 28) and IVB (n = 18, pre-PPV bevacizumab). Vitreous 1wk before injection of bevacizumab, visual acuity between the two groups, iatrogenic retinal hole incidence, intraoperative and postoperative bleeding. Results: At 1 month after operation, visual acuity was significantly increased in PPV group and IVB group (82.1% vs 88.9%, P <0.01). There was no significant difference between the two groups. The incidence of iatrogenic retinal breaks was 18 in PPV group and 4 in IVB group (64.3% vs 22.2%) (P <0.05). There were 28 cases in PPV group, 7 cases in IVB group (100% vs 39%) (P <0.01), 9 cases in PPV group and 0 cases in IVB group (32.1% vs 0). CONCLUSION: Bevacizumab preoperatively reduces the incidence of iatrogenic retinal tears, intraoperative bleeding and postoperative bleeding in vitreous surgery with proliferative diabetic retinopathy.