贝伐单抗辅助玻璃体切除术治疗增生性糖尿病视网膜病变

目的:探讨玻璃体切割术前玻璃体腔注射贝伐单抗(Bevacizumab,Avastin)治疗糖尿病视网膜病变的临床应用价值。方法:选取我院收治的增生性糖尿病视网膜病变患者20例(20眼)分A,B两组,每组10例(10眼)。A组直接行玻璃体切割手术,B组于玻璃体切割术前玻璃体腔注射0.05 ml/1.25 mg Avastin。记录两组病例严重程度评分(complexity score,CS)评估其严重性。两组病例的平均CS为5.5,且两组的CS相近。记录两组患者手术时间及手术中的情况。结果:A组的手术时间为104 min,B组为72 min;术中发生严重出血需眼内电凝止血的病例A组6例,B组1例。B组病例在玻璃体腔注射Avastin后没有出现严重并发症。术后6个月B组病例视力有不同程度的提高,A组视力提高不明显,且B组病例10例均保持视网膜平伏,A组则是8例保持视网膜平伏,2例发生视网膜脱离。结论:在玻璃体切割术前玻璃体腔注射Avastin可以使新生血管消退,减少术中出血,易化手术过程,缩短手术时间,并且术后没有明显的并发症。

Pars Plana Vitrectomy Assisted by Bevacizumab for Proliferative Diabetic Retinopathy

Objective:To evaluate the preoperative application of intravitreal bevacizumab(IVB) in patients undergoing pars plana vitrectomy(PPV) for proliferative diabetic retinopathy(PDR).Methods:Twenty patients with PDR were involved in this study and a preoperative complexity score(CS) was recorded.Ten eyes were treated with 1.25 mg IVB for 7 days before PPV(group B),and another 10 eyes underwent PPV(group A) without IVB treatment.The average CS was 5.5,and was similar in the two groups.Surgical time and intra-operative maneuvers were recorded.Results:Mean surgical time was 104 minutes in group A versus 72 minutes in group B;intraoperative bleeding cases were 6 versus 1,and endodiathermy cases were 6 versus 1.No complications were recorded after IVB.In the sixth month after the surgery,the visual acuity of group B had been improved,while that of group A had not.Anatomical attachment was achieved in 10 patients in group B versus eight patients in group A.Conclusion:IVB administered prior to vitrectomy is well tolerated and reduces active neovascularization,thus facilitates PPV procedures without increasing side effects.