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Kinya Tsubota, Yoshihiro Wakabayashi, Shunichiro Ueda, Yoshihiko Usui, Jun Suzuki, Hiroshi Goto; Effectiveness of prophylactic intravitreal bevacizumab injection in preventing complications after vitrectomy for proliferative diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):198.
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We previously reported that high intraocular VEGF concentration before vitrectomy for proliferative diabetic retinopathy (PDR) was associated with a high incidence of post-vitrectomy complications such as early vitreous hemorrhage (VH) and neovascular glaucoma (NVG) (Wakabayashi et al. IOVS 2012). In this study, we examined the effectiveness of intravitreal bevacizumab (IVB) injection given to patients with elevated preoperative intraocular VEGF concentration for the prevention of postoperative complications of PDR.
We studied 27 patients (28 eyes) with PDR who underwent vitrectomy first time at the Department of Ophthalmology, Tokyo Medical University Hospital between April and October 2012. The mean postoperative follow-up period was 3.4 months (1-6 months). The VEGF concentration in the vitreous humor collected at the time of vitrectomy was measured by ELISA. IVB injection was conducted after operation in patients with vitreous VEGF levels exceeding 1,000 pg/ml. The incidence of early VH and newly developed NVG after vitrectomy was investigated. New bleeding occurring within 1 month after operation was defined as early VH. investigated. New bleeding occurring within 1 month after operation was defined as early VH.
IVB injection was performed in 5 eyes (18%) in which vitreous VEGF concentrations exceeded 1,000 pg/ml. The mean duration from vitrectomy to IVB injection was 7.4 days (3-12 days). None of the 5 eyes that received IVB developed early VH and NVG. All 23 eyes (82%) with vitreous VEGF concentrations lower than 1,000 pg/ml also had no postoperative complications.
Prophylactic IVB given to patients with elevated preoperative intraocular VEGF concentration is effective for preventing postoperative early VH and NVG.
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