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AIM: To explore the efficacy of preoperative intravitreal injection of conbercept combined with 25G+ pars plana vitrectomy(PPV)in the treatment of proliferative diabetic retinopathy(PDR).METHODS: The clinical data of 154 patients(176 eyes)with PDR admitted to our hospital from January 2019 to June 2021 were collected for retrospective analysis. According to the treatment methods, 80 patients(92 eyes)in combined treatment group were treated with preoperative intravitreal injection of conbercept combined with 25G+PPV, and 74 patients(84 eyes)in control group were given 25G+PPV only. The postoperative clinical efficacy and levels of adipokines [adiponectin(APN), retinol binding protein 4(RBP4)] before and after surgery were compared between both groups of patients.RESULTS: The combined treatment group showed better clinical efficacy than the control group at 1mo after surgery(P<0.05). Both groups had lower RBP4 levels at 3mo after surgery(P<0.05), with the combined treatment group showing a lower level than the control group(P<0.05). Serum APN levels significantly increased in both groups after surgery(P<0.05), with the combined treatment group having a higher level than the control group(P<0.05). The combined treatment group had lower incidence rates of retinal proliferation and postoperative complications after than the control group 3mo of follow-up(P<0.05).CONCLUSION: Preoperative intravitreal injection of conbercept combined with 25G+PPV is beneficial in improving the therapeutic effect of PDR and reducing the incidence rates of complications, which may be related to the regulations of the expressions of adipokines.
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@#AIM: To analyze the hemostatic effect and mechanism of triamcinolone acetonide in the treatment of proliferative diabetic retinopathy(PDR).<p>METHODS: Totally 400 patients were treated in our hospital for PDR between January 2013 and March 2014. All subjects were divided into groups. The control group was treated with vitrectomy directly. The observation group was treated with triamcinolone acetonide at 4-14d before surgery. The differences of the indexes and complications in postoperative vision correction were compared between the two groups.<p>RESULTS: The expression levels of u-PA, t-PA and PAI-1 in the observation group were significantly higher than those in the control group(<i>P</i><0.01). The operation time and blood loss during the observation period were significantly lower in the observation group than in the control group(<i>P</i><0.01). The incidence of retinal breaks and vitreous hemorrhage in the group was significantly lower than that in the control group(<i>P</i><0.05). The incidence of macular edema after the operation was significantly lower than that in the control group(<i>P</i><0.01).<p>CONCLUSION: Vitrectomy in patients with PDR is often accompanied by hemorrhage and various complications. The use of triamcinolone acetonide can regulate the level of multiple clotting factors in the vitreous cavity of the patient, thereby reducing the amount of bleeding or directly exerting hemostasis, increasing surgical safety, reducing the incidence of complications, which is worthy of clinical application.