Authors: Ma Lie, Li Xiaoxin
Abstract [Download PDF] [Read Full Text]
Background
Vitrectomy is a primary approach to the treatment of proliferative diabetic retinopathy (PDR). However, postoperative rehaemorrhagia often occur.Ranibizumab is an effective drug of anti-vascular endothelial growth factor, but whether the combination of intravitreal injection of ranibizumab with vitrectomy can reduce the incidence of postoperative rehaemorrhagia in PDR patients is still unclear.
Objective
This study was to investigate the preventive effect of the combination of intravitreal injection of ranibizumab with 25-gauge vitrectomy on postoperative rehaemorrhagia.
Methods
A retrospective cohort study was perfomed.The clinical data of Ⅴ-Ⅵ stage of PDR patients who received 25-gauge vitrectomy in Peking University International Hospital from January 2014 to July 2015 were collected and analyzed.The PDR patients were divided into only surgery group and drug with surgery group.The patients in the only surgery group (34 eyes of 49 patients ) received 25-gauge vitrectomy, and the patients in the drug with surgery group (32 eyes of 25 patients) received the intravitreal injection of ranibizumab 0.05 ml (0.5 mg) 7 days before 25-gauge vitrectomy.The distribution of eye number in different grades of visual acuities was observed and compared between the two groups in 1 day, 1 week, 1 month and 3 months after surgery, and the incidence of rehaemorrhagia was intergrouply compared in 1 day, 3-7 days and 1 month after surgery.
Results
The eye number and percentage of the different visual acuities in the drug with surgery group was not significantly different from the only surgery group in 1 day, 1 week, 1 month and 3 months after surgery (1 day: Z=0.673, P=0.412; 1 week: Z=0.113, P=0.737; 1 month: Z=1.755, P=0.185; 3 months: Z=2.474, P=0.116). Rehaemorrhagia occurred in postoperative day 1 and day 3-7 was 1 eye and 1 eye respectively in the drug with surgery group, and that in the only surgery group was 9 eyes and 9 eyes respectively, showing significant difference between the two groups (all at P<0.05). The eye number of rehaemorrhagia in postoperative 1 month was 4 in the only surgery group, and no rehaemorrhagia appeared in the drug with surgery group.
Conclusions
The combination of intravitreal injection of ranibizumab with 25-gauge vitrectomy can efficiently reduce the incidence of postoperative rehaemorrhagia.