Session Title: Vitreo Retinal Surgery I
Session Date/Time: Thursday 11/09/2014 | 08:00-10:00
Paper Time: 09:36
First Author: : A.Gomaa EGYPT
Co Author(s): : Y. Hegazy
This study was designed to compare the efficacy of preoperative versus intraoperative intra-vitreal bevacizumab (IVB) injection in preventing postoperative vitreous hemorrhage (VH) following pars plana vitrectomy for complications of PDR.
The study was conducted in the faculty of Medicine , Alexandria University, in the period between October 2010 and June 2012.
This study included 96 eyes of 86 patients undergoing pars plana vitrectomy (PPV) for complications of PDR such as severe non-clearing vitreous hemorrhage and/or tractional retinal detachment. Eligible eyes were randomly assigned to one of three groups: Group A (17 eyes) received 1.25 mg IVB injection 1 to 7 days before PPV; Group B (36 eyes) received 1.25 mg IVB injection at the end of surgery; and Group C (43 eyes) did not receive any intravitreal injection.
At 1 month after surgery, the incidence of early postoperative VH was 17.6%, 11.1% and 9.3% in Group A, B and C, respectively, with no significant difference between the three groups. Mild vitreous hemorrhage was the major component of early postoperative VH in all study groups. At 3 months after surgery, the incidence of late postoperative VH was 0.0%, 5.6% and 9.3% in Group A, B and C, respectively, with no significant difference between the three groups. Analysis of changes in the mean BCVA at 1 and 3 month after surgery showed significant improvement from the preoperative BCVA in all study groups, although there was no significant difference between the three groups. The incidence of cataract development at 3 month was 50.0%, 31.8% and 45.8% in Group A, B and C, respectively. At 1 month, the duration of DM, iatrogenic retinal breaks and type of vitreous substitute did not affect the severity of early postoperative VH. Also, the severity of early postoperative VH was not decreased by preoperative PRP, irrespective of IVB injection. There was a significant relationship between the severity of early postoperative VH and the stage of PDR at 1 month only in eyes not receiving IVB injection.
Pars plana vitrectomy for complications of PDR is associated with significant improvement in visual acuity, a low incidence of early postoperative vitreous hemorrhage and a further lower incidence of late postoperative vitreous hemorrhage, irrespective of intravitreal bevacizumab injection- whether preoperative or intraoperative.