Aims: To compare the amount of intraoperative intraocular bleeding in diabetic patients with macula-involving tractional retinal detachment (TRD) undergoing pars plana vitrectomy (PPV) with and without preoperative intravitreal bevacizumab (IVB) injection.
Methods: An institutional study was carried out with consecutive patients with diabetic retinopathy and macula-involving TRD of recent (3 months) onset who were randomly assigned to PPV only (PPV group) or PPV combined with one IVB (1.5mg/0.06mL) injection 2 weeks prior to surgery (BEV/PPV group). All patients underwent 23-gauge PPV 3 weeks after baseline. The main outcome measure was erythrocyte count in the fluid retrieved from the vitrectomy cassette using a Neubauer counting chamber.
Results: The study included 20 patients. The mean (standard deviation) erythrocyte count was 14865 x 1000 (±19332 x 1000; median, 4500 x 1000) cells in the BEV/PPV group, and 176240 x 1000 (±108375 x 1000; median, 166600 x 1000) cells in the PPV group. The mean erythrocyte count was significantly lower in the BEV/PPV group compared with PPV group (P < 0.0001). No major adverse events were identified.
Conclusion: Preoperative IVB injection was associated with reduced intraocular bleeding during 23-gauge PPV for diabetic macula-involving TRD. Further studies are needed to confirm our preliminary findings.
Clinical trial register: NCT00690768
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