Ghasemi Falavarjani K, Hashemi M, Modarres M, Hadavand Khani A
Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Eye (Lond). 2014 May;28(5):576-80. doi: 10.1038/eye.2014.21. Epub 2014 Feb 21.
To evaluate the role of bevacizumab injected into the silicone oil at the end of retinal reattachment surgery for rhegmatogenous retinal detachment (RRD) associated with severe proliferative vitreoretinopathy (PVR) for prevention of postoperative PVR and compare the results with those without intrasilicone injection.
In this prospective comparative interventional study, eyes with RRD with grade C PVR were included. Standard 20 gauge pars plana vitrectomy, and retinal reattachment was performed. In case group, 1.25 mg bevacizumab was injected into the silicone oil at the end of surgery. The rate of retinal redetachment associated with PVR was assessed.
In all 38 eyes of 38 patients (19 cases and 19 controls) with a mean age of 46.6 ± 18.3 years were studied. The two groups were matched for age, sex, preoperative visual acuity, presence of anterior and posterior PVR, extent of PVR, and history of previous retinal detachment surgery. Retinal redetachment with PVR occurred in nine (47.3%) and seven (36.8%) eyes in case and control groups, respectively (P=0.5). Extensive subretinal fibrous proliferations in addition to preretinal membranes occurred more in the case group (55.5 vs 14.3%). At final visit, visual acuity was similar between the two groups (1.6 ± 0.8 and 1.6 ± 0.6, respectively, P=0.9).
Intrasilicone injection of bevacizumab at the end of vitrectomy for RRD with severe PVR does not eliminate the risk of postoperative PVR.
评估在视网膜复位手术结束时将贝伐单抗注入硅油中对伴有严重增生性玻璃体视网膜病变(PVR)的孔源性视网膜脱离(RRD)预防术后PVR的作用,并将结果与未进行硅油内注射的情况进行比较。
在这项前瞻性对比干预研究中,纳入患有C级PVR的RRD患者的眼睛。进行标准的20G玻璃体切除术并实现视网膜复位。病例组在手术结束时将1.25mg贝伐单抗注入硅油中。评估与PVR相关的视网膜再脱离发生率。
共研究了38例患者的38只眼(19例病例组和19例对照组),平均年龄为46.6±18.3岁。两组在年龄、性别、术前视力、有无前后段PVR、PVR程度以及既往视网膜脱离手术史方面相匹配。病例组和对照组分别有9只眼(47.3%)和7只眼(36.8%)发生了伴有PVR的视网膜再脱离(P=0.5)。病例组除视网膜前膜外还出现广泛视网膜下纤维增生的情况更多(55.5%对14.3%)。在最后一次随访时,两组视力相似(分别为1.6±0.8和1.6±0.6,P=0.9)。
对于伴有严重PVR的RRD患者,在玻璃体切除术后将贝伐单抗注入硅油中并不能消除术后PVR的风险。