Bevacizumab prior to vitrectomy for diabetic traction retinal detachment

• Published in: Eye (London) 2011-08, Vol.25 (8), p.989-997
• Main Authors: Pokroy, R, Desai, U R, Du, E, Li, Y, Edwards, P
• Format: Article
• Language: English
• Subjects: 631/92/436/108; 692/699/2743/137/138; 692/700/565/1436; 692/700/565/545; Adult; Aged; Angiogenesis Inhibitors - administration & dosage; Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal, Humanized; Bevacizumab; Biological and medical sciences; Clinical Study; Diabetes. Impaired glucose tolerance; Diabetic Retinopathy - physiopathology; Diabetic Retinopathy - surgery; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Humans; Intravitreal Injections; Laboratory Medicine; Length of Stay; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Miscellaneous; Ophthalmology; Pharmaceutical Sciences/Technology; Preoperative Care - methods; Retinal Detachment - physiopathology; Retinal Detachment - surgery; Retinal Neovascularization - physiopathology; Retinal Neovascularization - prevention & control; Retinopathies; Retrospective Studies; Selection Bias; Surgery; Surgical Oncology; Treatment Outcome; Visual Acuity; Vitrectomy - methods
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/eye.2011.149

Purpose To assess the efficacy and safety of preoperative intravitreal bevacizumab (IVB) before vitrectomy for diabetic tractional retinal detachment (TRD). Methods Using ICD-9 codes, we located all patients with diabetic TRD who underwent 3-port 20-gauge vitrectomy primarily performed by one surgeon between January 2004 and January 2009. Eyes receiving IVB were compared with those not. The following outcomes were compared: visual acuity (VA), duration of surgery, and complication rates. Results A total of 99 eyes of 90 patients were included in the analysis. In all, 34 patients received IVB on an average of 11.5 (range, 3–30) days previtrectomy. Age was 46.5 and 51.6 in the IVB and non-IVB groups, respectively. VA was improved significantly in both groups: from 20/617 to 20/62 in the IVB group, and from 20/443 to 20/86 in the non-IVB group ( P =0.11 between groups). Operating time and postoperative complications (glaucoma, RD, and revitrectomy rate) were similar in both groups. On comparing IVB and non-IVB eyes in younger patients (≤40), operating time was shorter ( P =0.02) and a trend to better VA in the IVB group was seen. Conclusions Preoperative IVB may be a useful adjunct to vitrectomy for severe PDR complicated by TRD, particularly in younger diabetics.