The effect of intravitreal injection of ranibizumab combined with vitrectomy to treat proliferative diabetic retinopathy / 中华眼底病杂志

ABSTRACT

Objective To observe the clinical effect of intravitreal ranibizumab (IVR) combined with vitrectomy in treating proliferative diabetic retinopathy (PDR).Methods This is a prospective non-randomized controlled clinical study.A total of 62 patients (70 eyes) who underwent vitrectomy for PDR were enrolled and divided into IVR group (30 patients,34 eyes) and control group (32 patients,36 eyes).IVR group patients received an intravitreal injection of 0.05 ml ranibizumab solution (10 mg/ml) 3 or 5 days before surgery.The follow-up time was 3 to 18 months with an average of (4.5± 1.8) months.The surgical time,intraoperative bleeding,iatrogenic retinal breaks,use of silicone oil,the best corrected visual acuity (BCVA) and the incidence of postoperative complications were comparatively analyzed.Results The difference of mean surgical time (t=6.136) and the number of endodiathermy during vitrectomy (t=6.128) between IVR group and control group was statistically significant (P=0.000,0.036).The number of iatrogenic retinal break in IVR group is 8.8 ％ and control group is 27.8％,the difference was statistically significant (x2 =4.154,P=0.032).Use of silicone oil of IVR group is 14.7％ and control group is 38.9％,the difference was statistically significant (x2 =5.171,P=0.023).The incidence of postoperative vitreous hemorrhage in 3 month after surgery was 11.8％ and 30.6 ％ respectively in IVR group and control group.The differences were statistically significant (x2=3.932,P=0.047).The 6 month postoperative mean BCVA of IVR group and control group have all improved than their preoperative BCVA,the difference was statistically significant (t=4.414,8.234;P=0.000).But there was no difference between the mean postoperative BCVA of two groups (t=0.111,P=0.190).There was no topical and systemic adverse reactions associated with the drug after injection in IVR group.Conclusions Microincision vitreoretinal surgery assisted by IVR for PDR shorten surgical time,reduces the intraoperative bleeding and iatrogenic retinal breaks,reduces the use of silicon oil and the postoperative recurrent vitreous hemorrhage.But there was no significant relationship between vision improvement and IVR.