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术前联合应用贝伐单抗和组织型纤溶酶原激活物在增生性糖尿病视网膜病变玻璃体切除术中的应用。

Preoperative co-application of bevacizumab and tissue plasminogen activator in vitrectomy for proliferative diabetic retinopathy.

机构信息

Department of Ophthalmology, Medicine Faculty, Istanbul Medipol University, Istanbul, Turkey.

Department of Ophthalmology, The Princess Alexandra Hospital NHS Trust, London, UK.

出版信息

Arq Bras Oftalmol. 2024 Mar 4;87(2):e20230001. doi: 10.5935/0004-2749.2023-0001. eCollection 2024.

Abstract

PURPOSE

To investigate the clinical benefits of the co-application of bevacizumab and tissue plasminogen activator as adjuncts in the surgical treatment of proliferative diabetic retinopathy.

METHODS

Patients who underwent vitrectomy for proliferative dia-betic retinopathy complications were preoperatively given in-travitreal injection with either bevacizumab and tissue plasminogen activator (Group 1) or bevacizumab alone (Group 2). Primary outcomes were surgery time and number of intraoperative iatrogenic retinal breaks. Secondary outcomes included changes in the best-corrected visual acuity and postoperative complications at 3 months postoperatively.

RESULTS

The mean surgery time in Group 1 (52.95 ± 5.90 min) was significantly shorter than that in Group 2 (79.61 ± 12.63 min) (p<0.001). The mean number of iatrogenic retinal breaks was 0.50 ± 0.59 (0-2) in Group 1 and 2.00 ± 0.83 (0-3) in Group 2 (p<0.001). The best-corrected visual acuity significantly improved in both groups (p<0.001). One eye in each group developed retinal detachment.

CONCLUSION

Preoperative co-application of bevacizumab and tissue plasminogen activator as adjuncts in the surgical treatment of proliferative diabetic retinopathy shortens the surgery time and reduces the number of intraoperative iatrogenic retinal breaks.

摘要

目的

研究贝伐单抗和组织纤溶酶原激活物联合应用于增生性糖尿病视网膜病变手术治疗的临床益处。

方法

对接受玻璃体切除术治疗增生性糖尿病视网膜病变并发症的患者,术前分别给予玻璃体内注射贝伐单抗联合组织纤溶酶原激活物(第 1 组)或贝伐单抗单独注射(第 2 组)。主要结局是手术时间和术中医源性视网膜裂孔的数量。次要结局包括最佳矫正视力的变化和术后 3 个月的术后并发症。

结果

第 1 组的平均手术时间(52.95 ± 5.90 分钟)明显短于第 2 组(79.61 ± 12.63 分钟)(p<0.001)。第 1 组的医源性视网膜裂孔平均数量为 0.50 ± 0.59(0-2)个,第 2 组为 2.00 ± 0.83(0-3)个(p<0.001)。两组的最佳矫正视力均显著提高(p<0.001)。每组各有 1 只眼发生视网膜脱离。

结论

在增生性糖尿病视网膜病变的手术治疗中,术前联合应用贝伐单抗和组织纤溶酶原激活物可缩短手术时间,减少术中医源性视网膜裂孔的数量。

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