J Korean Ophthalmol Soc > Volume 50(5); 2009 > Article
Journal of the Korean Ophthalmological Society 2009;50(5):731-737.
DOI: https://doi.org/10.3341/jkos.2009.50.5.731    Published online May 15, 2009.
Intravitreal Bevacizumab Injection as Preoperative Adjuvant of Vitrectomy for Proliferative Diabetic Retinopathy.
Min Kyu Shin, Na Mi Kim, Ji Eun Lee, Boo Sup Oum
1Department of Ophthalmology, School of Medicine, Pusan National University, Busan, Korea.
2Medical Research Institute, Pusan National University, Busan, Korea.
증식당뇨망막병증환자에서 유리체절제술 전 유리체강내 베바시주맙 주입의 효과
Department of Ophthalmology, School of Medicine, Pusan National University1, Busan, Korea / Medical Research Institute, Pusan National University2, Busan, Korea
The effect of preoperative intravitreal bevacizumab (Avastin(R)) injection was investigated in primary vitrectomy for severe proliferative diabetic retinopathy. METHODS: Eyes that underwent vitectomy for proliferative diabetic retinopathy were followed up at least 6 months and were reviewed retrospectively. The authors reviewed functional outcomes, complications, and operation time between preoperative bevacizumab injection (group I) and non-injection groups(group II). RESULTS: Among 93 eyes of 87 patients, the injection group consisted of 44 eyes of 41 patients and the non-injection gauge group consisted of 49 eyes of 46 patients. The mean interval between injection and vitrectomy was 5.8 days. Final visual acuity significantly improved as compared to preoperative visual acuity, and group I showed better visual acuity than group II (p=0.008). Visual acuity improved logMAR 0.2 or more in 36 eyes in group I and 43 eyes in group II (p=0.167). The average duration of postoperative vitreous hemorrhage was 1.02 days in group I, and 4.02 days in group II (p=0.2.08). Recurrence of vitreous hemorrhage was not observed in group I or in 2 eyes of group II (p=0.274). Epiretinal membrane occurred in 2 eyes of group I, and in 9 eyes of group II (p=0.031). Only a single eye in group I had neovascular glaucoma after vitrectomy (p=0.527). The operation time of group I was 64.8 minutes, which was significantly shorter than 78.1 minutes of group II (p=0.018). CONCLUSIONS: Intravitreal bevacizumab injection before vitrectomy in proliferative diabetic retinopathy facilitated removal of the fibrovascular membrane, and leads to less postoperative complications and better functional outcomes. Intravitreal bevacizumab injection before vitrectomy can be considered as an effective preoperative adjuvant.
Key Words: Bevacizumab (Avastin);Diabetic retinopathy;Epiretinal membrane;Vitrectomy;Vitreous hemorrhage

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