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A systematic review and meta-analysis of clinical outcomes of vitrectomy with or without intravitreal bevacizumab pretreatment for severe diabetic retinopathy.

机译:对有或没有玻璃体贝伐珠单抗进行严重糖尿病性视网膜病变的玻璃体切除术临床结果的系统评价和荟萃分析。

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AIMS: To examine possible benefits of intravitreal bevacizumab (IVB) pretreatment in vitrectomy for severe diabetic retinopathy. METHODS: A comprehensive literature search was performed using the Cochrane Collaboration methodology to identify randomised controlled trials and comparative studies of vitrectomy with or without IVB pretreatment for severe or complicated diabetic retinopathy. Meta-analyses were performed for intraoperative (including intraoperative bleeding, endodiathermy, iatrogenic retinal tears and mean surgical time) and postoperative outcome parameters (including best-corrected visual acuity, recurrent vitreous haemorrhage, reabsorption time of blood and other complications). RESULTS: Six randomised controlled trials and one comparative study were identified and used for comparing vitrectomy alone (142 eyes, control group) with vitrectomy with IVB pretreatment (139 eyes). The intraoperative findings showed that the incidence of intraoperative bleeding and frequency of endodiathermy were statistically significantly less in the IVB pretreatment group (p<0.01) than in the vitrectomy alone group. The IVB pretreatment group took significantly less surgical time than the control group (p=0.003). Postoperative results indicated that reabsorption time of blood was significantly shorter (p=0.04), incidence of recurrent VH was almost significantly less (p=0.05), and final best-corrected visual acuity was significantly better (p=0.003) in the IVB group than in the control group. Other complications, including final retinal detachment, and reoperation, were statistically insignificant. CONCLUSION: IVB pretreatment in vitrectomy can achieve excellent clinical outcomes for severe diabetic retinopathy. It potentially facilitates surgeons' manoeuvres and reduces intra- and postoperative complications.
机译:目的:探讨玻璃体内贝伐单抗(IVB)预处理在玻璃体切除术中治疗严重糖尿病性视网膜病变的可能益处。方法:使用Cochrane协作方法进行全面的文献检索,以鉴定进行或不进行IVB预处理的严重或复杂性糖尿病性视网膜病变的玻璃体切除术的随机对照试验和比较研究。进行了术中(包括术中出血,内透热,医源性视网膜撕裂和平均手术时间)和术后结果参数(包括最佳矫正视力,复发性玻璃体出血,血液重吸收时间和其他并发症)的荟萃分析。结果:确定了六项随机对照试验和一项比较研究,用于比较玻璃体切除术(142眼,对照组)与玻璃体切除术与IVB预处理(139眼)的比较。术中发现表明,IVB预处理组的术中出血发生率和内透热发生率在统计学上显着低于单纯玻璃体切除术组(p <0.01)。 IVB预处理组的手术时间明显少于对照组(p = 0.003)。术后结果表明,IVB组的血液重吸收时间显着缩短(p = 0.04),复发性VH发生率几乎显着降低(p = 0.05),并且最终最佳矫正视力明显更好(p = 0.003)。比对照组。其他并发症,包括最终的视网膜脱离和再次手术,在统计学上不显着。结论:玻璃体切除术中的IVB预处理可对严重的糖尿病性视网膜病变取得出色的临床效果。它有可能促进外科医生的操作并减少术中和术后并发症。

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