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Intraoperative bleeding during vitrectomy for diabetic tractional retinal detachment with versus without preoperative intravitreal bevacizumab (IBeTra study)
  1. D da R Lucena1,
  2. J A S Ribeiro1,
  3. R A Costa1,2,
  4. J C Barbosa3,
  5. I U Scott4,
  6. L L de Figueiredo-Pontes5,
  7. R Jorge1
  1. 1
    Department of Ophthalmology, School of Medicine of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
  2. 2
    MacIma—Macular Imaging & Treatment Division, Hospital de Olhos de Araraquara, Araraquara, São Paulo, Brazil
  3. 3
    Department of Exact Sciences, São Paulo State University, Jaboticabal, São Paulo, Brazil
  4. 4
    Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
  5. 5
    Laboratory of Hematology, School of Medicine of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
  1. Professor R Jorge, Setor de Retina e Vítreo, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Avenida Bandeirantes 3900, Ribeirão Preto-SP, CEP 14049-900, Brasil; rjorge{at}


Aims: To compare the amount of intraoperative intraocular bleeding in patients with diabetes 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 (1.5 mg/0.06 ml) injection 2 weeks prior to surgery (bevacizumab (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 erythrocyte count was 14 865×103 (SD 19 332×103; median 4500×103) cells in the BEV/PPV group, and 176 240×103 (SD 108 375×103; median 166 600×103) cells in the PPV group. The mean erythrocyte count was significantly lower in the BEV/PPV group than in the 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.

Trial registration number: NCT00690768.

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  • Competing interests: None.

  • Funding: Partially supported by CNPq (Brazilian National Council for Scientific and Technological Development), grant no 302940/2005-7.

  • Ethics approval: Ethics approval was provided by the local institutional review board (Comitê de Ética em Pesquisa HCRP e FMRP-USP).

  • Patient consent: Obtained.

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