The effect of intravitreal ranibizumab on intraoperative bleeding during pars plana vitrectomy for diabetic traction retinal detachment.

摘要

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 haemo-stasis and avoid iatrogenic retinal breaks.Based on the promising results using bevacizumab before PPV,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.