Intravitreal Conbercept Injection as an Adjuvant in Vitrectomy with Silicone Oil Infusion for Severe Proliferative Diabetic Retinopathy
Intravitreal Conbercept Injection as an Adjuvant in Vitrectomy with Silicone Oil Infusion for Severe Proliferative Diabetic Retinopathy
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DOI：
10.1089/jop.2019.0149
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发表时间：
2020-03-18
影响因子：
2.3
通讯作者：
Shen, Xi
中科院分区：
文献类型：
--
作者：
Gao, Shuang;Lin, Zhongjing;Shen, Xi
目的：评价术前、术中或术前联合术中玻璃体内注射康柏西普（Conbercept，IVC）在玻璃体切除硅油填充术治疗重度增殖性糖尿病视网膜病变（PDR）中的临床效果。方法：98例98眼接受玻璃体切除硅油填充术的重度PDR患者随机分为3组：第1组（34只眼）于术前35 d行下腔静脉注射;第2组（35只眼）于术毕行下腔静脉注射;第3组（29只眼）于术前35 d及术毕行下腔静脉注射。结果：两组术中出血的发生率及严重程度差异无统计学意义（P = 0.233）。然而，与第2组相比，第1组和第3组的手术持续时间明显缩短（P < 0.001）。早期和晚期复发性玻璃体积血（VH）的发生率分别为32.35%、28.57%和13.80%。在6个月随访时，第1组的平均最佳矫正视力显著增加至1.25 +/- 0.45 logMAR，第2组为1.29 +/- 0.46 logMAR，第3组为1.16 +/- 0.44 logMAR（均P < 0.001）。第3组术后VH、新生血管性青光眼和视网膜脱离的发生率略低，但差异无统计学意义（均P > 0.05）。在年轻患者中，观察到类似的结果，第3组的视力改善更好（P = 0.037）。结论：术前IVC注射可以是一个安全和有效的辅助玻璃体切割联合硅油填充治疗严重PDR。术前结合术中IVC是有希望的，特别是在年轻患者中。
Purpose: To assess the clinical effects of preoperative, intraoperative, or preoperative combined with intraoperative intravitreal conbercept (IVC) injection in vitrectomy with silicone oil tamponade for severe proliferative diabetic retinopathy (PDR).Methods: Ninety-eight eyes of 98 severe PDR patients undergoing vitrectomy with silicone oil tamponade were randomly assigned to 3 groups: Group 1 (34 eyes) received IVC injections 3 to 5 days before surgery; Group 2 (35 eyes) received IVC injections at the end of surgery; and Group 3 (29 eyes) received IVC injections 3 to 5 days before and at the end of operation. Follow-up examinations were performed for 6 months.Results: The incidence and severity of intraoperative bleeding were not significantly different (P = 0.233). However, the duration of surgery was significantly shorter in Group 1 and Group 3 compared with Group 2 (P < 0.001). The incidences of early and late recurrent vitreous hemorrhage (VH) were 32.35%, 28.57%, and 13.80%, respectively. At 6-month follow-up, mean best-corrected visual acuity had significantly increased to 1.25 +/- 0.45 logMAR in Group 1, 1.29 +/- 0.46 logMAR in Group 2, 1.16 +/- 0.44 logMAR in Group 3 (all P < 0.001). The incidence of postoperative VH, neovascular glaucoma, and retinal detachment in Group 3 was slightly lower, however, no significant differences were observed (all P > 0.05). In young patients, similar results were observed and Group 3 had better visual improvements (P = 0.037).Conclusions: Preoperative IVC injection could be a safe and effective adjunct in pars plana vitrectomy with silicone oil tamponade for severe PDR. Preoperative combined with intraoperative IVC are promising, especially in young patients.