Abstract
Objective:To evaluate the effect of preoperative intravitreal bevacizumab injection on the incidence of postoperative haemorrhage and visual prognosis, in patients undergoing 25-gauge micro incision vitrectomy surgery (MIVS) for diabetic vitreous haemorrhage.Methods:One hundred and twenty two eyes of 122 patients of diabetic retinopathy of both genders and aged over 18 years, who presented with non-resolving vitreous haemorrhage were enrolled for this study. All patients received an intravitreal injection of 1.25 mg/0.05 mL bevacizumab (Avastin) which was followed one week later by 25-gauge sutureless micro incision vitrectomy surgery. Main outcomes measured were best corrected visual acuity (BCVA) assessed with logMAR and post-operative vitreous haemorrhage. Follow ups were up to six months post-operatively. IBM SPSS 21 was used for data analysis.Result:A total of 122 patients were included; 78 (63.9%) males and 44 (36.1%) females. Mean age at the time of surgery was 51.4 ± 13.66 years. The mean preoperative BCVA was 1.64 ± 0.427 logMAR which improved to 0.57 ± 0.253 logMAR at 12 months post-operatively (p-value < 0.001). Recurrent vitreous haemorrhage was seen in four patients (3.28%).one1 week before 25-gauge vitrectomy helps to reduce the incidence of early post-vitrectomy haemorrhage in diabetic patients.
Highlights
The prevalence of proliferative diabetic retinopathy (PDR) among diabetic patients in1
The rationale of this study was to evaluate the effect of preoperative intravitreal bevacizumab injection on the incidence of postoperative haemorrhage in patients with proliferative diabetic retinopathy (PDR), undergoing 25-gauge micro incision vitrectomy surgery (MIVS) for diabetic vitreous haemorrhage
Since the postoperative haemorrhage usually occurs within the first few days after surgery, the vascular endothelial growth factor (VEGF) blockade provided by a single dose of bevacizumab for four weeks is sufficient to prevent postoperative bleeding in the vast majority of cases.[12]
Summary
The prevalence of proliferative diabetic retinopathy (PDR) among diabetic patients in. Pan retinal photocoagulation (PRP) remains the primary treatment for PDR, but once complications occur, such as vitreous haemorrhage or tractional retinal detachment, vitrectomy surgery is advocated.[3,4] In 1975, O’Malley developed the first 20-gauge 3-port pars plana vitrectomy (PPV).[5] The instruments and technology involved in this procedure has seen a significant progression over the last few decades and transconjunctival suture less 25-gauge micro incision vitrectomy system (MIVS) are in common use today. The rationale of this study was to evaluate the effect of preoperative intravitreal bevacizumab injection on the incidence of postoperative haemorrhage in patients with proliferative diabetic retinopathy (PDR), undergoing 25-gauge micro incision vitrectomy surgery (MIVS) for diabetic vitreous haemorrhage. Secondary outcomes measures included changes in best-corrected visual acuity (BCVA) and IVB-related adverse events
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