Bevacizumab pretreatment and long-acting gas infusion on vitreous clear-up after diabetic vitrectomy
Bevacizumab pretreatment and long-acting gas infusion on vitreous clear-up after diabetic vitrectomy
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DOI：
10.1016/j.ajo.2008.04.028
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发表时间：
2008-08-01
影响因子：
4.2
通讯作者：
Chen, Muh-Shy
中科院分区：
文献类型：
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作者：
Yang, Chung-May;Yeh, Po-Ting;Chen, Muh-Shy
目的：评价贝伐单抗联合10%C3F8玻璃体腔内注射对糖尿病玻璃体切除术后早期玻璃体出血清除速度的影响。设计：前瞻性、非随机、对照病例研究。方法：前瞻性、非随机、对照病例研究。方法：对15例(16眼)活动性增殖性糖尿病视网膜病变(PDR)患者行玻璃体切割术，术后随访6个月以上。术前1周玻璃体腔内注射贝伐单抗1.25 mg/0.05ml，术中玻璃体腔内注入10%C3F8。比较两组术中出血严重程度、玻璃体清除时间延长(2~3周)的百分比及再出血情况，并与单纯注气组(24例24眼)进行比较。玻璃体透明时间研究组为7.2±5.6天，对照组为15.2±11.4天(P=0.04)。玻璃体透明时间延长(3周)分别为1例(6.3%)和9例(37.5%)(P=0.03)。早期玻璃体出血率两组分别为0/16(0%)和1/24(4.2%)(P=0.41)。多因素Logistic回归分析显示，贝伐单抗可缩短玻璃体透明时间。结论：贝伐单抗联合C3F8 10%输液可有效辅助玻璃体切除术后玻璃体透明，对活动性PDR患者有效。
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 (2: 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.