Department of Ophthalmology, Ruijin Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Ophthalmology, Shibei Hospital of Jingan District, Shanghai, China.
J Ocul Pharmacol Ther. 2020 Jun;36(5):304-310. doi: 10.1089/jop.2019.0149. Epub 2020 Mar 18.
To assess the clinical effects of preoperative, intraoperative, or preoperative combined with intraoperative intravitreal conbercept (IVC) injection in vitrectomy with silicone oil tamponade for severe proliferative diabetic retinopathy (PDR). Ninety-eight eyes of 98 severe PDR patients undergoing vitrectomy with silicone oil tamponade were randomly assigned to 3 groups: Group 1 (34 eyes) received IVC injections 3 to 5 days before surgery; Group 2 (35 eyes) received IVC injections at the end of surgery; and Group 3 (29 eyes) received IVC injections 3 to 5 days before and at the end of operation. Follow-up examinations were performed for 6 months. The incidence and severity of intraoperative bleeding were not significantly different ( = 0.233). However, the duration of surgery was significantly shorter in Group 1 and Group 3 compared with Group 2 ( < 0.001). The incidences of early and late recurrent vitreous hemorrhage (VH) were 32.35%, 28.57%, and 13.80%, respectively. At 6-month follow-up, mean best-corrected visual acuity had significantly increased to 1.25 ± 0.45 logMAR in Group 1, 1.29 ± 0.46 logMAR in Group 2, 1.16 ± 0.44 logMAR in Group 3 (all < 0.001). The incidence of postoperative VH, neovascular glaucoma, and retinal detachment in Group 3 was slightly lower, however, no significant differences were observed (all > 0.05). In young patients, similar results were observed and Group 3 had better visual improvements ( = 0.037). Preoperative IVC injection could be a safe and effective adjunct in pars plana vitrectomy with silicone oil tamponade for severe PDR. Preoperative combined with intraoperative IVC are promising, especially in young patients.
评估术前、术中或术前联合术中玻璃体内康柏西普（IVC）注射在硅油眼内填充玻璃体切割术治疗严重增生性糖尿病视网膜病变（PDR）中的临床效果。98 例严重 PDR 患者接受硅油眼内填充玻璃体切割术，随机分为 3 组：组 1（34 只眼）于术前 3 至 5 天接受 IVC 注射；组 2（35 只眼）于手术结束时接受 IVC 注射；组 3（29 只眼）于术前 3 至 5 天和手术结束时接受 IVC 注射。术后随访 6 个月。术中出血的发生率和严重程度无显著差异（=0.233）。然而，组 1 和组 3 的手术时间明显短于组 2（<0.001）。早期和晚期复发性玻璃体积血（VH）的发生率分别为 32.35%、28.57%和 13.80%。6 个月随访时，组 1 的最佳矫正视力平均提高至 1.25±0.45 logMAR，组 2 提高至 1.29±0.46 logMAR，组 3 提高至 1.16±0.44 logMAR（均<0.001）。组 3 的术后 VH、新生血管性青光眼和视网膜脱离的发生率略低，但无显著差异（均>0.05）。在年轻患者中观察到类似的结果，且组 3 的视力改善更好（=0.037）。对于严重 PDR，术前 IVC 注射联合硅油眼内填充玻璃体切割术是一种安全有效的辅助治疗方法。术前联合术中 IVC 可能更有前途，尤其是在年轻患者中。
