Abstract

Purpose. To determine the efficacy and safety of preoperative intravitreal conbercept (IVC) injection before vitrectomy for proliferative diabetic retinopathy (PDR). Methods. 107 eyes of 88 patients that underwent pars plana vitrectomy (PPV) for active PDR were enrolled. All patients were assigned randomly to either preoperative IVC group or control group. Follow-up examinations were performed for three months after surgery. The primary bioactivity measures were severity of intraoperative bleeding, incidence of early and late recurrent VH, vitreous clear-up time, and best-corrected visual acuity (BCVA) levels. The secondary safety measures included intraocular pressure, endophthalmitis, rubeosis, tractional retinal detachment, and systemic adverse events. Results. The incidence and severity of intraoperative bleeding were significantly lower in IVC group than in the control group. The average vitreous clear-up time of early recurrent VH was significantly shorter in IVC group compared with that in control group. There was no significant difference in vitreous clear-up time of late recurrent VH between the two groups. Patients that received pretreatment of conbercept had much better BCVA at 3 days, 1 week, and 1 month after surgery than control group. Moreover, both patients with improved BCVA were greater in IVC group than in control group at each follow-up. Conclusions. Conbercept pretreatment could be an effective adjunct to vitrectomy in accelerating postoperative vitreous clear-up and acquiring stable visual acuity restoration for PDR.

Highlights

  • Proliferative diabetic retinopathy (PDR) is a severe and common complication of diabetes mellitus (DM) linked to permanent vision loss or blindness all over the world

  • A total of 122 eyes of 96 patients were enrolled in the study and assigned randomly into two groups: 58 eyes in intravitreal conbercept (IVC) group and 64 eyes in control group

  • 54 eyes of 46 patients were included in preoperative intravitreal conbercept group, and control group consisted of 53 eyes of 42 patients (Figure 1)

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Summary

Introduction

Proliferative diabetic retinopathy (PDR) is a severe and common complication of diabetes mellitus (DM) linked to permanent vision loss or blindness all over the world. Pars plana vitrectomy (PPV) is the cornerstone of management for advanced complications of PDR. Intraoperative or postvitrectomy vitreous hemorrhage (VH) often occurred to make the visibility too muddy to accomplish surgery favorably. What is more, it could result in retinal detachment or other adverse complications [1, 2]. Angiogenesis is the pathophysiology base of PDR [3]. Vascular endothelial growth factor (VEGF) has been confirmed to be a key driver of the neovascularization, vascular permeability, diabetic macular edema, and PDR [4,5,6]

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