Preoperative intravitreal bevacizumab effects on the course of Pars Plana vitrectomy in diabetic vitreous hemorrhage

Abstract

PurposeTo compare the rate of rehemorrhage in patients with diabetic vitreous hemorrhage (VH) undergoing pars plana vitrectomy (PPV) with versus without preoperative intravitreal bevacizumab (IVB) injectionMethodsForty patients with proliferative diabetic retinopathy (40 eyes) with an indication for primary vitrectomy were randomized to IVB group (20 eyes) or control group (20 eyes). Intravitreal bevacizumab group received intravitreal injection of 1.25 mg/0.05 mL bevacizumab, 1 week before vitrectomyResultsThe frequency of postoperative recurrent vitreous hemorrhage (5%, 1/20 vs. 40%, 8/20, P = 0.017) were significantly lower in IVB group than in control group .The number of intraoperative endodiathermy spots (0.63 ± 1.0 vs. 1.3 ± 1.4, P = 0.028) were also significantly lower in IVB group than in control group while mean bleeding frequency in IVB group was 0.7 ± 0.78 times/case with range between 0 and 2 bleeding attacks/case and mean bleeding frequency in control group was 3.12 ± 1.31 times/case with range between 3 and 6 bleeding attacks/case and the difference was statistically significant as (p < 0.001). The frequency of reoperation due to recurrent vitreous hemorrhage within 4 weeks after surgery was significantly lower (P = 0.022) in IVB group (5%, 1 patient) than in control group (35%, 7/20)ConclusionsIntravitreal injection of 1.25 mg/0.05 mL bevacizumab 1 week before vitrectomy blocked vascular endothelial growth factor production in vitreous and significantly reduced the incidence of reoperation due to early postoperative recurrent vitreous hemorrhage.