Abstract
Purpose :
To identify vitreous hemorrhage (VH) recurrence rate in diabetic patients during the one-month postoperative visit after pars plana vitrectomy (PPV) with bevacizumab injection either before or during surgery.
Methods :
Retrospective chart review was performed for 104 patients that underwent PPV for diabetic VH at the University of Kansas Medical Center during the past three years. Patients who received bevacizumab injection intraoperatively or within 30 days before surgery were included. Patients who were not compliant with postoperative follow-up were excluded. Data collection included LogMAR visual acuity, age, gender, type of diabetes, bevacizumab injection status, vitreous status, and postoperative course. This study was approved by the Institutional Review Board of the University of Kansas School of Medicine.
Results :
Forty-eight patients met the study inclusion criteria (27 females, 21 males), with an average age of 52±12.87 years old. The preoperative bevacizumab injection group had 18 patients (53.7±15.43 years old) (9 females, 9 males), including eight patients with tractional retinal detachment (TRD). After one month, four patients (22.2%) had recurrent VH, including one (5.6%) who needed repeat surgery for blood removal. The intraoperative bevacizumab injection group had 30 patients (51±11.22 years old) (18 females, 12 males), including 12 patients with concurrent TRD. After one month, five patients (16.7%) had recurrent VH, including three patients (10%) who needed repeat surgery for blood removal. There was no statistically significant difference between groups regarding size (p=0.11), age (p=0.52), gender (p=0.71), VH recurrence rate at one month (p=0.92), or need for repeat surgery (p=1).
Conclusions :
Early postoperative VH recurrence impacts patients’ outcomes and expectations. Our study did not detect a significant difference in VH recurrence at one month after surgery when bevacizumab was injected intraoperatively or within 30 days before surgery. Intraoperative bevacizumab injection may be useful in diabetic patients with VH when bevacizumab cannot be administered preoperatively. Larger prospective trials are needed to further clarify the long-term outcome in similar patients.
This is a 2021 ARVO Annual Meeting abstract.