玻璃体腔内注射贝伐单抗对增生性糖尿病视网膜病变玻璃体手术的影响(英文)

Effect of intravitreal bevacizumab injection before vitrectomy on proliferative diabetic retinopathy

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。

AIM： To evaluate the effect of intravitreal bevacizumab （IVB） injection 1 week before pars plana vitrectomy （PPV） in proliferative diabetic retinopathy （PDR） patients. METHODS： A retrospective research was done on 46 PDR patients who were divided into PPV group （n=28） and IVB group （n=18, PPV with preoperative IVB）. Bevacizumab was injected 1 week before PPV. Main outcome measures were visual acuity, incidence of iatrogenic retinal breaks, intraoperative and postoperative bleeding. RESULTS： At 1 month after surgery, visual acuity in PPV （82.1%） and IVB group （88.9%） improved significantly （P〈0.01） and the difference between the two groups was not significant. Iatrogenic retinal breaks were reported in 18 cases （64.3%） in PPV group and 4 cases （22.2%） in IVB group （P〈0.05）. Intraoperative bleeding was encountered in all cases in PPV group and 7 cases （39%） in IVB group （P〈0.01）. Postoperative bleeding was reported in 9 cases （32.1%） in PPV group and none in IVB group （P〈0.01）. CONCLUSION： IVB injection before PPV is helpful in reducing iatrogenic retinal breaks, intraoperative and postoperative bleeding in PDR patients.