Efficacy of vitrectomy assisted by intravitreal conbercept injection for the treatment of severe proliferative diabetic retinopathy

Objective

To evaluate the efficacy of preoperative intravitreal conbercept injection (IVC) before pars plana vitrectomy for severe proliferative diabetic retinopathy (PDR).

Methods

A non-randomized controlled study was adopted.Fifty-seven severe PDR patients were collected in Tianjin Eye Hospital from January 2015 to June 2016.The patients were divided into two groups, 30 eyes in the preoperative IVC group, and 30 eyes in the simple PPV group (control group). Operation time, intraoperative bleeding, LogMAR BCVA and complications were compared.This study protocol was approved by Ethic Committee of Tianjin Eye Hospital (No.TJYYLL-2015-14) and this study followed the Declaration of Helsinki.

Results

The average operation duration was (95.4±15.8)minutes in the preoperative IVC group, which were significantly shorter than (107.0±11.3)minutes in the control group, with a significant difference between them (t=-3.28, P=0.00). The incidence of endodiathermy was lower in the preoperative IVC group (16.67%, 5/30) than that in the control group (43.33%, 13/30), with a significant difference between them (χ²=5.08, P=0.02). The mean BCVAs were significantly different among the two groups of different time points (F_group=0.59, P=0.45; F_time=61.80, P<0.01). The mean postoperative LogMAR BCVA was 0.95±0.46 in the preoperative IVC group, which was improved compared with the preoperative results (1.37±0.45), the difference was statistically significant (t=5.62, P<0.01). The mean postoperative LogMAR BCVA was 1.03±0.53 in the control group, which was improved compared with the preoperative results (1.46±0.50), the difference was statistically significant (t=5.50, P=0.00). There was no significant difference between the mean postoperative BCVA of two groups (t=-0.673, P=0.500). The number of postoperative complication was reported in 6 eyes (20%) in the preoperative IVC group, while 15 eyes (50%) were reported in the control group, the difference was statistically significant (χ²=5.93, P=0.02).

Conclusions

Conpared with vitrectomy, vitrectomy assisted by intravitreal conbercept injection for severe PDR can shorten the operation time, reduce the intraoperative bleeding, improve the visual acuity and reduce the incidence of postoperative complications.

Proliferative diabetic retinopathy; Vitrectomy; Anti-vascular endothelial growth factor/Conbercept; Intravitreal injection