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Rocky L. McAdams, Richard Winslow, Georges Bounajem; Does Preoperative Intravitreal Bevacizumab Reduce The Incidence Or Severity Of Postoperative Diabetic Vitreous Hemorrhage?. Invest. Ophthalmol. Vis. Sci. 2012;53(14):353.
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To examine the impact of preoperative intravitreal bevacizumab injections prior to vitrectomy on the rate of postoperative vitreous hemorrhage in diabetics with non-clearing vitreous hemorrhage or tractional retinal detachments.
A retrospective chart review was conducted using ICD-9 and CPT codes to identify 121 eyes with proliferative diabetic retinopathy being treated with pars plana vitrectomy at Parkland Hospital between 2006 and 2010. Chart review was done to pull pertinent data from all preoperative and up to 3 months postoperative visits including the use of bevacizumab.
At 1 week and at 3 months post op the rate of any significant hemorrhage was 12.5 % and 26.9% in the bevacizumab group compared to 26.2% and 45.8% respectively in the observation group. These results trend to have decreased rate of hemorrhage in the injection group. The timing of the injection did not show a statistical difference in the measured outcome.
The results suggest a trend toward decreased rates of postoperative vitreous hemorrhage with a preoperative bevacizumab injection in patients with non clearing vitreous hemorrhage and tractional retinal detachments from proliferative diabetic retinopathy. Further research is still needed to establish the value of implementing preoperative therapy in this important postoperative complication.
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