Ranibizumab Pretreatment in Vitrectomy with Internal Limiting Membrane Peeling on Diabetic Macular Edema in Severe Proliferative Diabetic Retinopathy

摘要

AimTo evaluate the efficacy of intravitreal ranibizumab (IVR) pretreatment for pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling in severe proliferative diabetic retinopathy (PDR) combined with macular edema (ME).MethodsSixty-three patients with ME and PDR were divided into IVR and control groups. Three days before PPV stripping, ranibizumab was injected into the patients in the IVR group. The patients were followed for 6?months. The best-corrected visual acuity (BCVA), visual acuity improvement, centre macular thickness (CMT), and intraoperative and postoperative complications were compared between the two groups.ResultsThe BCVA of the IVR group was significantly improved at 1, 3 and 6?months compared with the preoperative BCVA ( P ?0.01). The BCVA of the control group was significantly improved at 3 and 6?months compared with the preoperative BCVA ( P ?0.01), but was not significantly improved at 1?month. At 1 and 3?months, the BCVA of the IVR group was significantly better than that of the control group after surgery, with no difference between the two groups at 6?months. The CMT of the IVR group was thinner than that of the control group at 1 and 3?months ( P ?0.01), with no significant difference at 6?months after surgery. The surgical time, the risk of intraoperative bleeding, the incidence of iatrogenic retinal breaks, the frequency of endodiathermy and the rate of silicone oil tamponade were significantly different between the two groups (all P ?0.05). There was no significant difference between the two groups in terms of postoperative complications.ConclusionsRanibizumab pretreatment may improve the outcome of PPV with ILM peeling for severe PDR with ME by decreasing ME and intraoperative complications.