Department of Ophthalmology, School of Medicine, Kyungpook National University, #50 Samduk-dong-2-ga, Chung-gu, Taegu 700-721, South Korea.
Graefes Arch Clin Exp Ophthalmol. 2010 May;248(5):641-50. doi: 10.1007/s00417-009-1247-7. Epub 2009 Dec 12.
To study the clinical outcome and complications of intravitreal bevacizumab (IVB) versus triamcinolone acetonide (IVT) injections at the end of vitrectomy in patients with diabetic vitreous hemorrhage.
This is a retrospective comparative case study comprised of 156 eyes from 139 consecutive patients who underwent pars plana vitrectomy for diabetic vitreous hemorrhage (VH) with or without tractional retinal detachment (TRD). IVB (1.25 mg/0.05 ml) injection was done for 66 eyes (60 patients) and IVT (4 mg/0.1 ml) injection for 33 eyes (31 patients) at the end of vitrectomy, and no injection was done for 57 eyes (48 patients). Main outcome measures were best-corrected visual acuity (BCVA), intraocular pressure (IOP), and incidence of postoperative VH and reoperation with at least 12 months of follow-up.
Early postoperative VH within 1 month postoperatively occurred in eight eyes (12.1%) from the IVB group, three eyes (9.1%) from the IVT group, and 21 eyes (36.8%) from the control group. The rate of early postoperative VH was significantly lower in the IVB and IVT group than the control group (p = 0.002 and 0.006, respectively). Late postoperative VH after 1 month postoperatively occurred in 11 eyes (16.7%) from the IVB group, three eyes (9.1%) from the IVT group, and 12 eyes (21.1%) from the control group. There was no difference between the three groups (P = 0.341). BCVA of the IVB, IVT, and control group at postoperative months 1, 3, 6, 9, and 12 significantly improved from the preoperative BCVA (p < 0.01, respectively). There was no difference for BCVA between the three groups at each follow-up period (p > 0.05). In only the IVT group, IOP at postoperative day 1 was higher than IOP preoperatively (p = 0.002). There was no significant difference in the rate of reoperation between the three groups (p = 0.275).
IVB and IVT injection at the end of diabetic vitrectomy is a useful adjunctive therapy for reducing early postoperative VH compared to the control group. IVB injection does not have a risk of a temporary rise of IOP, which the IVT group has.
研究玻璃体切割术结束时玻璃体内注射贝伐单抗（IVB）与曲安奈德（IVT）治疗糖尿病玻璃体积血的临床效果和并发症。
这是一项回顾性对比病例研究，共纳入 139 例连续患者的 156 只眼，这些患者因糖尿病玻璃体积血（VH）合并或不合并牵拉性视网膜脱离（TRD）行玻璃体切除术。玻璃体切割术结束时，66 只眼（60 例）接受 IVB（1.25mg/0.05ml）注射，33 只眼（31 例）接受 IVT（4mg/0.1ml）注射，57 只眼（48 例）未接受注射。主要观察指标为最佳矫正视力（BCVA）、眼内压（IOP）以及术后 12 个月以上的术后 VH 和再次手术的发生率。
术后 1 个月内，IVB 组有 8 只眼（12.1%）、IVT 组有 3 只眼（9.1%）、对照组有 21 只眼（36.8%）出现早期术后 VH。IVB 组和 IVT 组的早期术后 VH 发生率明显低于对照组（p=0.002 和 0.006）。术后 1 个月后，IVB 组有 11 只眼（16.7%）、IVT 组有 3 只眼（9.1%）、对照组有 12 只眼（21.1%）出现晚期术后 VH。三组间无差异（P=0.341）。IVB、IVT 和对照组在术后 1、3、6、9 和 12 个月时的 BCVA 均较术前显著提高（p<0.01）。在每个随访期，三组间的 BCVA 均无差异（p>0.05）。仅在 IVT 组，术后第 1 天的 IOP 高于术前（p=0.002）。三组间的再手术率无差异（p=0.275）。
与对照组相比，玻璃体切割术结束时玻璃体内注射 IVB 和 IVT 是减少术后早期 VH 的有效辅助治疗方法。IVB 注射不会像 IVT 组那样导致眼压暂时升高。
