Intravitreal bevacizumab as an adjunctive therapy before diabetic vitrectomy

Ashraf M El-BatarnyAssistant Professor of Ophthalmology, Tanta University, Egypt; Chief of Vitreoretinal Service, Magrabi Eye and Ear Hospital, Muscat, Sultanate of OmanPurpose: To evaluate the effect of intravitreal injection of Avastin, bevacizumab (IVA) on diabetic vitrectomy and on the postopera...

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Autor principal:	Ashraf M El-Batarny
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2009
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/7671c2dab229430a910ca56cc86a9e04
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spelling	oai:doaj.org-article:7671c2dab229430a910ca56cc86a9e042021-12-02T02:57:41ZIntravitreal bevacizumab as an adjunctive therapy before diabetic vitrectomy1177-54671177-5483https://doaj.org/article/7671c2dab229430a910ca56cc86a9e042009-02-01T00:00:00Zhttp://www.dovepress.com/intravitreal-bevacizumab-as-an-adjunctive-therapy-before-diabetic-vitr-a2854https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Ashraf M El-BatarnyAssistant Professor of Ophthalmology, Tanta University, Egypt; Chief of Vitreoretinal Service, Magrabi Eye and Ear Hospital, Muscat, Sultanate of OmanPurpose: To evaluate the effect of intravitreal injection of Avastin, bevacizumab (IVA) on diabetic vitrectomy and on the postoperative course.Methods: Thirty patients undergoing diabetic vitrectomy were distributed to standard vitrectomy (group 1) or vitrectomy with preoperative IVA (group 2). Bevacizumab was injected 5 to 7 days before surgery. Patients of both groups were matched as much as possible according to surgical indication and preoperative visual acuity. Main outcome measures were the feasibility of surgery and the postoperative complications. Feasibility of surgery was evaluated through recording surgical time, intraoperative bleeding, use of endodiathermy, relaxing retinotomies, use of perfluorocarbon liquid (PFCL) and silicone oil tamponade.Results: Follow up ranged between 7 and 18 months. There was significant reduction of mean surgical time, bleeding frequency, and diathermy use in group 2 compared to group 1. The rate of PFCL use and relaxing retinotomies were less in group 2 in comparison to group 1. Gas or air was used in 80% of patients in group 2 while silicone oil represented 60% of group 1. Postoperative visual acuity improvement was highly significant in both groups but the difference in both groups was not statistically significant. Vision improved in 87% in group 2 and 80% in group 1. Primary anatomical attachment was achieved in 90.3% in group 2 and 86.6% in group 1. Rate of subsequent surgeries and persistent cataract were higher in group 1. Postoperative bleeding was reported in 26.6% of cases in group 1 and none in group 2. In group 2, no complications related to avastin injection or progression of traction were reported during the preoperative period.Conclusion: Preoperative IVA was helpful in achieving the surgical and anatomical goals by reducing the time of surgery, the intraoperative and postoperative bleeding, and the use of silicone oil with subsequent reduction of second surgery.Keywords: intravitreal bevacizumab, proliferative diabetic retinopathy, diabetic vitrectomy, vascular endothelial growth factor, diabetic vitreous hemorrhage Ashraf M El-BatarnyDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2008, Iss Issue 4, Pp 709-716 (2009)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Ashraf M El-Batarny Intravitreal bevacizumab as an adjunctive therapy before diabetic vitrectomy
description	Ashraf M El-BatarnyAssistant Professor of Ophthalmology, Tanta University, Egypt; Chief of Vitreoretinal Service, Magrabi Eye and Ear Hospital, Muscat, Sultanate of OmanPurpose: To evaluate the effect of intravitreal injection of Avastin, bevacizumab (IVA) on diabetic vitrectomy and on the postoperative course.Methods: Thirty patients undergoing diabetic vitrectomy were distributed to standard vitrectomy (group 1) or vitrectomy with preoperative IVA (group 2). Bevacizumab was injected 5 to 7 days before surgery. Patients of both groups were matched as much as possible according to surgical indication and preoperative visual acuity. Main outcome measures were the feasibility of surgery and the postoperative complications. Feasibility of surgery was evaluated through recording surgical time, intraoperative bleeding, use of endodiathermy, relaxing retinotomies, use of perfluorocarbon liquid (PFCL) and silicone oil tamponade.Results: Follow up ranged between 7 and 18 months. There was significant reduction of mean surgical time, bleeding frequency, and diathermy use in group 2 compared to group 1. The rate of PFCL use and relaxing retinotomies were less in group 2 in comparison to group 1. Gas or air was used in 80% of patients in group 2 while silicone oil represented 60% of group 1. Postoperative visual acuity improvement was highly significant in both groups but the difference in both groups was not statistically significant. Vision improved in 87% in group 2 and 80% in group 1. Primary anatomical attachment was achieved in 90.3% in group 2 and 86.6% in group 1. Rate of subsequent surgeries and persistent cataract were higher in group 1. Postoperative bleeding was reported in 26.6% of cases in group 1 and none in group 2. In group 2, no complications related to avastin injection or progression of traction were reported during the preoperative period.Conclusion: Preoperative IVA was helpful in achieving the surgical and anatomical goals by reducing the time of surgery, the intraoperative and postoperative bleeding, and the use of silicone oil with subsequent reduction of second surgery.Keywords: intravitreal bevacizumab, proliferative diabetic retinopathy, diabetic vitrectomy, vascular endothelial growth factor, diabetic vitreous hemorrhage
format	article
author	Ashraf M El-Batarny
author_facet	Ashraf M El-Batarny
author_sort	Ashraf M El-Batarny
title	Intravitreal bevacizumab as an adjunctive therapy before diabetic vitrectomy
title_short	Intravitreal bevacizumab as an adjunctive therapy before diabetic vitrectomy
title_full	Intravitreal bevacizumab as an adjunctive therapy before diabetic vitrectomy
title_fullStr	Intravitreal bevacizumab as an adjunctive therapy before diabetic vitrectomy
title_full_unstemmed	Intravitreal bevacizumab as an adjunctive therapy before diabetic vitrectomy
title_sort	intravitreal bevacizumab as an adjunctive therapy before diabetic vitrectomy
publisher	Dove Medical Press
publishDate	2009
url	https://doaj.org/article/7671c2dab229430a910ca56cc86a9e04
work_keys_str_mv	AT ashrafmelbatarny intravitrealbevacizumabasanadjunctivetherapybeforediabeticvitrectomy
_version_	1718402048156762112

Intravitreal bevacizumab as an adjunctive therapy before diabetic vitrectomy

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