Effectiveness of multistage surgical treatment of advanced proliferative diabetic retinopathy complicated with primary cataract

Li²,

Evidence-Based Complementary and Alternative Medicine

et al. 2021

Objective. To explore the effects of the anti-VEGF drug and glucocorticoid by injection before the end of vitrectomy for proliferative diabetic retinopathy (PDR). Methods. Eighty PDR patients who underwent vitrectomy in our hospital (July 2020–June 2022) were selected as the research objects and randomized into group A (n = 40) and group B (n = 40) according to the order of admission. Before the end of surgery, group B was injected with glucocorticoid (triamcinolone acetonide) into the vitreous cavity, and group A was injected with anti-VEGF drug (conbercept). The ophthalmic parameters, incidence of complications, diabetes indexes, and surgical indexes of the two groups were compared. Results. The best corrected visual acuity (BCVA), central macular thickness (CMT), macular blood flow density and intraocular pressure in group A were remarkably better than those in group B ( P < 0.001 ). The incidence of complications ( P < 0.05 ) and VEG/F level ( P < 0.001 ) in group A were obviously lower than those in group B. There was no significant difference in fasting blood glucose (FBG) and surgical indexes between the two groups ( P > 0.05 ). Conclusion. Conbercept injection before the end of vitrectomy can improve the ophthalmic parameters, reduce the level of VEGF, and lower the possibility of postsurgical complications. Therefore, the low-cost and efficient anti-VEGF drug should be promoted and applied in practice.

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of the Effects of the Anti-VEGF Drug and Glucocorticoid by Injection before the End of Vitrectomy for Proliferative Diabetic Retinopathy

Li²,

Evidence-Based Complementary and Alternative Medicine

et al. 2021

Güncel Retina (Current Retina)

“…Bu basamaklı cerrahinin görme artışı sağlaması açısından başarılı olduğunu bildirilmişler. [27] Rivas-Aguino ve ark. PPV, faoemülsifikasyon ve GİL implantasyonunun kombine olarak uygulandığı veya basamaklı olarak yapıldığı hastaları karşılaştırmışlar ve her iki cerrahi yöntemin kataraktın tedavisinde etkili olduğunu bildirmişlerdir.…”

Section: Diyabetik Hastalarda Basamaklı Katarakt Cerrahisiunclassified

Cataract Surgery Combined with Diabetic Vitrectomy and the Use of Intraoperative Optical Coherence Tomography

2023

The cataract develops 2-5 times higher in patients with Diabetes Mellitus (DM) than in the normal population. With the advances in modern surgical equipment and surgical techniques, cataract surgery combined with vitrectomy has become increasingly common among vitreoretinal surgeons. Cataract surgery combined with vitrectomy has its own difficulties. In addition to these difficulties, there are specific situations that should be considered in vitrectomy combined with cataract surgery in patients with DM. Optical Coherence Tomography(OCT) is an imaging method that provides high-resolution sections of ocular tissues. OCT devices integrated into the operating microscope are systems that allow real-time images to be taken during surgery. In this review, vitrectomy combined with cataract surgery and the use of intraoperative OCT in patients with diabetic retinopathy is discussed.

“…Учитывая то, что в настоящее время витреоретинальная хирургия применяется, как правило, при далеко зашедших стадиях ДР, а именно при ПДР, основная цель состоит в устранении ее проявлений (ТОС, ТРОС, гемофтальм), которые и являются показаниями к витрэктомии. При достижении этой цели удается сохранить, а как правило, и улучшить остроту зрения и увеличить поле зрения [47,48,53].…”

Section: витреоретинальная хирургияunclassified

“…В мировой литературе имеется огромное количество статей, посвященных лечению осложнений ПДР с помощью витрэктомии. Можно сказать, что витрэктомия выступает в качестве последней попытки сохранить глаз как орган с минимальными функциональными показателями при лечении ПДР, когда отсутствует эффект от ранее проведенной ПЛКС и анти-VEGF-терапии [48,53].…”

Section: витреоретинальная хирургияunclassified

“…Следует отметить, что в мировой практике такой подход не приветствуется, учитывая сложность выполнения операции, которая требует хорошего материально-технического оснащения, большого опыта хирурга. Витрэктомия при ДР также сопряжена с рядом возможных интраоперационных осложнений: ятрогенными разрывами сетчатки [54,63], отеком роговицы [64], повреждением хрусталика [52], интраоперационным кровотечением [52] и рядом послеоперационных осложнений в виде катаракты -39-57 % [51,65], рецидивирующего гемофтальма -11,4-20,0 % [66,67], отслойки сетчатки -1,5-4,3 % [68,69], повышения внутриглазного давления -7,9-20,0 % [70,71], неоваскулярной глаукомы -3,2-7,1 % [53,72], субатрофии глазного яблока -1 % [73], эндофтальмита -0,039 % [72].…”

Section: витреоретинальная хирургияunclassified

See 1 more Smart Citation

Role of Vitrectomy in the Treatment of Diabetic Retinopathy

Petrachkov¹,

Korobov²,

Arzhukhanov³

2021

Oftalʹmologiâ

Diabetic retinopathy (DR) is a socially significant disease with a steady tendency to increase, in which there is a high risk of disability due to persistent loss of vision. There are three main pathogenetically substantiated methods of DR treatment: laser coagulation of the retina; intravitreal injections of VEGF inhibitors, steroid drugs; vitreoretinal surgery. In the later stages of DR, vitrectomy is the main method of its complications treating, but there is no clear understanding of the timeliness of this operation. The analysis of the results of original research on this problem is carried out. It has been shown that with the advent of new instruments, modified vitrector, operating microscopes, viewing systems and vitreoretinal combines, vitrectomy led to a change in the paradigm of DR treatment. These advances have resulted in better surgical control and greater precision, while at the same time shorter surgical times and fewer surgical complications. There is a tendency to perform vitrectomy at earlier stages of DR, which has a pathogenetic rationale. This could be a leap forward in the treatment of DR as a preventive measure against the development of proliferative DR.