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The effect of intravitreal ranibizumab on intraoperative bleeding during pars plana vitrectomy for diabetic traction retinal detachment
  1. Jefferson A S Ribeiro1,
  2. André Messias1,
  3. Felipe P P de Almeida1,
  4. Rogério A Costa1,
  5. Ingrid U Scott2,
  6. Lorena L de Figueiredo-Pontes3,
  7. Rodrigo Jorge1
  1. 1Department of Ophthalmology, School of Medicine of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
  2. 2Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
  3. 3Laboratory of Hematology, School of Medicine of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
  1. Correspondence to Professor Dr Rodrigo 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 14049-900 Brazil; rjorge{at}

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Traction retinal detachment (TRD) is an important cause of visual impairment in patients with advanced proliferative diabetic retinopathy (PDR). It is treated surgically and involves removal of fibrovascular membranes and release of the vitreoretinal traction during pars plana vitrectomy (PPV), with special care taken to ensure haemostasis and avoid iatrogenic retinal breaks.1

Based on the promising results using bevacizumab before PPV,2–4 we evaluated the effect of another humanised anti-VEGF-A drug, intravitreal ranibizumab (IVR), on reducing intraoperative bleeding during 23-gauge PPV in 19 consecutive patients with macula-involving TRD of up to 3 months duration secondary to PDR and best-corrected visual acuity between 20/60 and 20/800. Patients were not enrolled if they had vitreous haemorrhage preventing detailed visualisation of the entire posterior retinal pole, previous intraocular surgery except for cataract surgery, any clinical condition that would impair the documentation of the ocular fundus, previous thromboembolic events, known clotting disorders or use of anticoagulant medications except aspirin, or significant and uncontrolled diseases that might interfere with study participation.

Patients were randomly assigned to administration of either …

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  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Local Committee of Ethics in Research HCRP and FMRP. This study protocol adhered to the principles of the Declaration of Helsinki and was approved by the local Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.