Bevacizumab Pretreatment and Long-acting Gas Infusion on Vitreous Clear-up After Diabetic Vitrectomy

Yang, Chung-May; Yeh, Po-Ting; Yang, Chang-Hao; Chen, Muh-Shy

doi:10.1016/j.ajo.2008.04.028

« Previous Next »American Journal of Ophthalmology
Volume 146, Issue 2 , Pages 211-217.e1, August 2008

Bevacizumab Pretreatment and Long-acting Gas Infusion on Vitreous Clear-up After Diabetic Vitrectomy

Chung-May Yang
- Department of Ophthalmology, National Taiwan University Hospital, and College of Medical, National Taiwan University, Taipei, Taiwan
- Inquiries to Chung-May Yang, Department of Ophthalmology, National Taiwan University Hospital; College of Medicine, National Taiwan University, No. 7, Chung Shan South Road, Taipei, Taiwan
Po-Ting Yeh
- Department of Ophthalmology, National Taiwan University Hospital, and College of Medical, National Taiwan University, Taipei, Taiwan
- Department of Ophthalmology, En Chu Kong Hospital, Taipei, Taiwan.
Chang-Hao Yang
- Department of Ophthalmology, National Taiwan University Hospital, and College of Medical, National Taiwan University, Taipei, Taiwan
Muh-Shy Chen
- Department of Ophthalmology, National Taiwan University Hospital, and College of Medical, National Taiwan University, Taipei, Taiwan

Accepted 15 April 2008. published online 22 May 2008.

Purpose

To evaluate the effects of bevacizumab pretreatment combined with intravitreal infusion of C₃F₈ 10% on the clearance speed of early postoperative vitreous hemorrhage in diabetic vitrectomy for eyes with active fibrovascular proliferation.

Design

Prospective, nonrandomized, comparative case study.

Methods

Sixteen eyes (15 patients) that underwent primary pars plana vitrectomy for active proliferative diabetic retinopathy (PDR) were prospectively enrolled with a follow-up period of six months or more. These cases received an intravitreal injection of bevacizumab (1.25 mg/0.05 ml) one week prior to surgery and intravitreal C₃F₈ 10% infusion during surgery. The severity of intraoperative bleeding, vitreous clear-up time, percentage of prolonged vitreous clear-up (≥ three weeks), and recurrent hemorrhage respectively were compared with those in a control group (24 eyes in 24 patients) that received gas infusion alone.

Results

The severity of intraoperative bleeding was significantly lower in the study group than in the control group. Vitreous clear-up time for the study group and the control group was 7.2 ± 5.6 days and 15.2 ± 11.4 days, respectively (P = .04). Prolonged vitreous clear-up time (≥ three weeks) was observed in one of 16 (6.3%) and nine of 24 (37.5%) of the cases, respectively (P = .03). Early recurrent vitreous hemorrhage rates in the two groups were zero of 16 (0%) and one of 24 (4.2%), respectively (P = .41). Multiple logistic regression analyses showed that bevacizumab pretreatment reduced vitreous clear-up time.

Conclusions

Bevacizumab pretreatment combined with C₃F₈ 10% infusion could be an effective adjunct to vitrectomy in accelerating postoperative vitreous clear-up for eyes with active PDR.