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

Abstract

Aim: To 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). Methods: Sixty-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 bestcorrected visual acuity (BCVA), visual acuity improvement, centre macular thickness (CMT), and intraoperative and postoperative complications were compared between the two groups. Results: The 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. Conclusions: Ranibizumab pretreatment may improve the outcome of PPV with ILM peeling for severe PDR with ME by decreasing ME and intraoperative complications.

Adjunctive Preoperative Ranibizumab (Luecentis) Before Vitrectomy for Vitreous Haemorrhage in Diabetics

“…It was revealed that the degree of CRT drop was linked to the improvement in BCVA (15) . Our study agrees with Guan et al (16) .…”

“…There was a significant difference between the two groups in terms of surgical duration, intraoperative bleeding risk, iatrogenic retinal break incidence, endodiathermy frequency, and silicone oil tamponade rate (all P 0.05). In terms of postoperative complications, there was no discernible difference between the two groups (16) . Proliferative diabetic retinopathy patients with mild and moderate VH may benefit from intravitreal ranibizumab injections.…”

Prognostic Evaluation of Vitrectomy Assisted by Lucentis in Diabetic Retinopathy and Neovascular Glaucoma

“…Guan et al [ 22 ] found that PPV with Lucentis preconditioning internal limiting membrane (ILM) peeling for severe proliferative DR complicated with macular edema (ME) could significantly ameliorate BCVA and CMT of patients and reduce postoperative complications such as operation time and intraoperative bleeding risk. Li et al [ 23 ] found that the combination of Lucentis and surgery for NVG can significantly control IOP and improve BCVA without serious complications.…”

Effectiveness and Safety of Coadministration of Intravitreal Dexamethasone Implant and Silicone Oil Endotamponade for Proliferative Diabetic Retinopathy with Tractional Diabetic Macular Edema

“…Intravitreal injection of anti-VEGF drugs 3 days before the operation may improve PPV results and facilitate ILM peeling. 30 In our study, for the same purposes, we injected IVR to all eyes 3 days before the PPV operation.…”