Abstract
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 charts of patients with diabetic TRD who underwent 3-port 20 gauge vitrectomy by a single 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: :
Ninety-nine eyes of 90 patients were included in the analysis. Thirty-four patients received IVB 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. Visual acuity 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, retinal detachment, revitrectomy rate) were similar in both groups. Upon 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: :
We conclude that preoperative IVB is a useful adjunct to vitrectomy in eyes with severe proliferative diabetic retinopathy complicated by TRD. The efficacy is most apparent in young diabetics.
Keywords: diabetic retinopathy • retinal detachment • vitreoretinal surgery